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BACKGROUND:Heart rate variability biofeedback is a respiratory training method that uses slow and deep breathing at the resonant frequency to induce rhythmic,high-amplitude oscillations in the cardiovascular system,thereby stimulating and exercising the autonomic and baroreflex.However,current studies have not systematically reviewed how heart rate variability biofeedback modulates the autonomic function and produces effects.There is a lack of public understanding of the mechanism of heart rate variability biofeedback,and its application progress and scheme are not fully understood. OBJECTIVE:To review the existing experimental studies on the effects of heart rate variability biofeedback on symptoms in different populations at home and abroad and to introduce the mechanisms and advances in the application of heart rate variability biofeedback to modulate the autonomic nervous system. METHODS:"Heart rate variability biofeedback,resonance breathing,heart rate variability,autonomic nerve,breathing training,chronic diseases,mental illness,biofeedback"were used as Chinese or English keywords to search in CNKI,WanFang Database,PubMed,and Web of Science.A total of 72 core related papers were included according to the inclusion and exclusion criteria. RESULTS AND CONCLUSION:The body's oscillation system and resonance system are essential for the effectiveness of heart rate variability biofeedback.Oscillations reflect the response to external stimuli and self-regulating reflex systems,while resonances involve synchronous oscillations that result in higher amplitude operations.The balance between sympathetic and parasympathetic nerves is crucial for maintaining a stable internal environment.Autonomic nervous system disorders are associated with reduced heart rate variability and are closely linked to the progression of related diseases.Heart rate variability biofeedback utilizes the resonance characteristics of the cardiovascular system,inducing rhythmic high-amplitude oscillations by employing deep slow breathing at the resonance frequency.This method improves the regulatory function of the sympathetic and parasympathetic system reflexes and enhances the balance regulation between the two systems.Two major mechanisms of cardiovascular system resonance are the baroreflex closed-loop pathway and respiratory sinus arrhythmia.These mechanisms,along with the unique delay of baroreflex,result in a 0° phase angle oscillation between heart rate and respiration and a 180° phase angle oscillation between blood pressure and respiration during breathing at the resonant frequency rhythm.Periodically stimulating the human cardiovascular oscillation system through this method is an easy-to-operate and effective training approach.Currently,heart rate variability biofeedback is mainly applied in the fields of mental illness,chronic disease,and sports.However,the intervention mechanism and efficacy are unclear,the intervention content,frequency and duration are varied,and there are limited review studies on the intervention methods tailored to different types of individuals.As a non-drug and non-invasive intervention,heart rate variability biofeedback can significantly increase heart rate variability,regulate the balance between sympathetic and parasympathetic nerves,and improve the stability and adaptability of the autonomic nervous system.In the future,it is suggested to investigate the mechanisms and potential applications of the pathways of the heart rate variability biofeedback that induce cardiovascular resonance.It is also recommended to incorporate long-term follow-ups to assess the sustained value of heart rate variability biofeedback in various fields.This would provide new directions and strategies for the comprehensive treatment of complex diseases.
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BACKGROUND:Trunk pressure biofeedback is considered a reliable indicator for assessing core muscle strength.It not only reflects the status of an individual's trunk strength but also has a close relationship with the function of respiratory muscles. OBJECTIVE:To explore the correlation between trunk pressure biofeedback and diaphragmatic function in young adults. METHODS:A total of 80 young adults from Shangrao Normal University,China were enrolled,including 34 males and 46 females,with an average age of(19.83±1.45)years.Diaphragmatic thickness and mobility were measured using a bedside musculoskeletal ultrasound system.Maximum inspiratory pressure was determined using a portable pulmonary function tester.Lumbar and abdominal pressures in prone and supine positions were assessed using a pressure biofeedback device.The degree of correlation between trunk pressure biofeedback and diaphragmatic function was determined using Pearson or Spearman correlation coefficients.A multivariate linear regression analysis was used to determine predictive models for diaphragmatic function. RESULTS AND CONCLUSION:Grouped by sex,age,height,body mass,trunk pressure biofeedback values,diaphragm thickness during quiet inspiration and expiration,diaphragmatic thickening ratio during quiet breathing,diaphragmatic thickness during deep inspiration and expiration,diaphragmatic thickening ratio during deep breathing,diaphragmatic mobility during deep inspiration,and maximum inspiratory pressure were higher in the male group than the female group(all P<0.05).Grouped by physical activity level,trunk pressure biofeedback values and maximum inspiratory pressure were lower in the sedentary group than in the exercise group(both P<0.05).Both anterior and posterior trunk pressure biofeedback were significantly correlated with diaphragmatic thickness during quiet inspiration and expiration,diaphragmatic thickening ratio during quiet breathing,diaphragmatic thickness during deep inspiration and expiration,diaphragmatic thickening ratio during deep breathing,diaphragmatic mobility during deep inspiration,and maximum inspiratory pressure(all P<0.01).Anterior trunk pressure biofeedback entered the predictive model for diaphragmatic thickness during quiet inspiration(F=27.228,P<0.001),during deep inspiration(F=38.615,P<0.001),and along with age for diaphragmatic mobility during deep inspiration(F=15.408,P<0.001).Anterior trunk pressure biofeedback,body mass,and age entered the predictive model for maximum inspiratory pressure(F=22.314,P<0.001).To conclude,there is a strong correlation between trunk pressure biofeedback and diaphragmatic thickness,diaphragmatic mobility,and maximum inspiratory pressure.The rapid and simple measurement of trunk pressure biofeedback can serve as a method for screening the diaphragmatic function in healthy young adults.
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Objective:To evaluate the effect of combining contralateral high-frequency transcranial magnetic stimulation (rTMS) with biofeedback-controlled empty swallowing training on dysphagia among stroke survivors.Methods:Eighty dysphagic stroke survivors were divided at random into a control group, a biofeedback group, an rTMS group and a combined treatment group, each of 20. In addition to routine dysphagia rehabilitation, the biofeedback group and the rTMS group received empty swallowing training based on biofeedback or high-frequency rTMS applied to the healthy motor cortex as appropriate. The combined treatment group was given both. The treatment was administered once daily, 5 days a week for 3 consecutive weeks. Before and after the treatment, all of the subjects′ swallowing was evaluated using the penetration aspiration scale (PAS), functional oral intake scale (FOIS) and a standardized swallowing assessment (SSA). The latency and amplitude of the mylohyoid muscle′s motor evoked potentials (MEPs) were also recorded before and after the treatment.Results:After the treatment, significant improvement was observed in the average PAS, FOIS and SSA scores as well as in the latency and amplitude of the MEPs in the four groups. The average results in the combined treatment group were significantly better than in the other 3 groups. The latency of the mylohyoid muscle′s MEP was significantly shorter in the combined group than in the control and biofeedback groups on average, while the amplitude was significantly greater than in the control group.Conclusion:Combining contralateral high frequency rTMS with empty swallowing training based on biofeedback can better improve the swallowing of dysphagic stroke survivors.
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Objective To analyze the clinical efficacy of biofeedback and electrical stimulation on pelvic organ prolapse(POP)after laparoscopic uterine suspension.Methods A total of 102 cases of POP patients admitted to our hospital were selected and divided into the control group and the observation group according to the random number table method,with 51 cases in each group.The patients in the control group were treated with laparoscopic uterine suspension,and the patients in the observation group were treated with biofeedback and electrical stimulation on the basis of the control group.The total effective rate,pelvic floor distress inventory-20(PFDI-20)score,pelvic floor impact questionnaire-7(PFIQ-7)score,female sexual function index(FSFI)score,pelvic incontinence sexual questionnaire(PISQ)score,and recurrence rate of the patients in the two groups were compared.A neuromuscular electrical stimulation therapy instrument was used to detect the recovery of pelvic floor muscle for patients before and after treatment.Results Compared with the control group,the efficacy of patients in the observation group was superior(P<0.05).The PFDI-20 and PFIQ-7 scores after treatment of patients in the two groups were decreased compared with those before treatment(P<0.05),and the PFDI-20 and PFIQ-7 scores after treatment of patients in the observation group were lower than those in the control group(P<0.05).The pelvic floor muscle strength,maximal muscle contraction force and sustained contraction time after treatment of patients in the two groups were significantly stronger/longer than those before treatment(P<0.05),and the pelvic floor muscle strength,maximal muscle contraction force and sustained contraction time after treatment of patients in the observation group were stronger/longer than those in the control group(P<0.05).The FSFI and PISQ scores after treatment of patients in the two groups were significantly increased compared with those before treatment(P<0.05),and the FSFI and PISQ scores after treatment in the observation group were higher than those in the control group(P<0.05).The recurrence rate after treatment of patients in the observation group was significantly lower than that in the control group(P<0.05).Conclusion Biofeedback and electrical stimulation can enhance the clinical efficacy of laparoscopic uterine suspension in the treatment of POP,improve the pelvic floor muscle strength and POP of patients,and improve their quality of life.
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Objective:To study the influence of electromyographic biofeedback therapy(EMGBFT)combined with mirror therapy(MT)on lower limb motor and balance function in stroke patients. Method:Sixty patients with hemiplegia after stroke were randomly divided into two groups:MT based EMG-BFT group and EMGBFT group,30 patients in each group.On the basis of conventional rehabilitation,the patients in the EMGBFT group received sham MT stimulation combined with EMGBFT,and the patients in the MT based EMGBFT group received MT combined with EMGBFT.Before and after treatment,the lower limb motor function of the patients was evaluated using Fugl-Meyer assessment scale-lower extremity(FMA-LE)and surface electromyography-integrated electromyography(iEMG)of knee flexion and ankle dorsiflex-ion,co-contraction ratio(CR).Plantar pressure-symmetry index(SI)of mean pressure and contact area of both feet,elliptical area of body center of gravity,anteroposterior(AP)and mediolateral(ML)displacement distance of body center of gravity under eye-opening and eye-closed states were calculated to evaluate pa-tients'weight-bearing and balance function. Result:After treatment,FMA-LE,CR and iEMG of biceps femoris and rectus femoris under knee flexion,tibialis anterior and medial gastrocnemius under ankle dorsiflexion were markedly ameliorated in the two groups(P<0.01).After treatment,in the eye-opening state,the SI of mean pressure and contact area of both feet,elliptical area of body center of gravity,AP and ML displacement distances of body center of gravity were greatly enhanced in the two groups(P<0.05,P<0.01),in the eye-closed state,the SI of mean pressure and contact area of both feet,ML displacement distances of body center of gravity were observably ameliorat-ed in the two groups(P<0.05,P<0.01).Compared with the EMGBFT group,the FMA-LE,iEMG of biceps femoris and tibialis anterior muscles,elliptical area of body center of gravity,AP and ML displacement dis-tance of body center of gravity with eyes open,SI of contact area of both feet with eyes closed had more significant changes in the MT based EMGBFT group after treatment(P<0.05,P<0.01). Conclusion:Electromyographic biofeedback therapy combined with mirror therapy can improve lower limb motor and balance function in stroke patients,the underlying mechanism of which may be the activation of lower limb weak muscle motor units,the relief of lower limb spasm,and the improvement of standing static balance ability.
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ABSTRACT Objective: To explore the effects of electric stimulation and biofeedback therapy in patients with postpartum pelvic organ prolapse and to identify factors that can affect therapeutic efficacy outcomes. Method: This retrospective study analysed clinical data about patients with postpartum pelvic organ prolapse. A total of 328 women with pelvic organ prolapse at 6 weeks postpartum were recruited from one tertiary hospitals in Sichuan province in China, between March 2019 and March 2022. The prognostic factors of therapeutic efficacy were analysed using logistic regression and decision tree model. Results: Overall, 259 women showed clinical benefits from the treatment. The logistic regression model showed that parity, pelvic floor muscle training at home, and the pelvic organ prolapse quantitation stage before treatment were independent prognostic factors. The decision tree model showed that the pelvic organ prolapse quantitation stage before treatment was the main prognostic factor, followed by parity. There was no significant difference in the area under the receiver operating characteristic curve between the two models. Conclusion: Parity, pelvic floor muscle training at home, and the pelvic organ prolapse quantitation stage before treatment were important prognostic factors of electric stimulation and biofeedback therapy on postpartum pelvic organ prolapse.
RESUMO Objetivo: Explorar o efeito da estimulação elétrica e da terapia de biofeedback em pacientes com prolapso de órgãos pélvicos pós-parto e identificar fatores que podem afetar os resultados da eficácia terapêutica. Método: Este estudo é uma análise retrospectiva de dados clínicos de pacientes com prolapso de órgãos pélvicos pós-parto. Um total de 328 mulheres com prolapso de órgãos pélvicos nas seis semanas pós-parto foram recrutadas em um hospital terciário na província de Sichuan, na China, entre março de 2019 e março de 2022. Os fatores prognósticos de eficácia terapêutica foram analisados por meio de regressão logística e modelo de árvore de decisão. Resultados: No geral, 259 mulheres apresentaram benefícios clínicos com o tratamento. O modelo de regressão logística mostrou que a paridade, o treinamento muscular do assoalho pélvico em casa e o estágio de quantificação do prolapso de órgãos pélvicos antes do tratamento foram fatores prognósticos independentes. O modelo de árvore de decisão mostrou que o estágio de quantificação do prolapso de órgãos pélvicos antes do tratamento foi o principal fator prognóstico, seguido pela paridade. Não houve diferença significativa na área sob a curva ROC entre os dois modelos. Conclusão: A paridade, o treinamento muscular do assoalho pélvico em casa e o estágio de quantificação do prolapso de órgãos pélvicos antes do tratamento foram importantes fatores prognósticos da estimulação elétrica e da terapia de biofeedback no prolapso de órgãos pélvicos pós-parto.
RESUMEN Objetivo: Explorar el efecto de la estimulación eléctrica y la terapia de biorretroalimentación en pacientes con prolapso posparto de órganos pélvicos e identificar los factores que pueden afectar los resultados de la eficacia terapéutica. Método: Este estudio es un análisis retrospectivo de los datos clínicos de pacientes con prolapso posparto de órganos pélvicos. Entre marzo de 2019 y marzo de 2022, se reclutaron un total de 328 mujeres con prolapso de órganos pélvicos en las seis semanas posteriores al parto en un hospital terciario de la provincia de Sichuan, China. Los factores pronósticos de eficacia terapéutica se analizaron mediante regresión logística y el modelo de árbol de decisión. Resultados: En total, 259 mujeres mostraron beneficios clínicos relacionados con el tratamiento. El modelo de regresión logística mostró que la paridad, el entrenamiento en casa de la musculatura del suelo pélvico y la etapa de cuantificación del prolapso de órganos pélvicos antes del tratamiento fueron factores pronósticos independientes. El modelo de árbol de decisión mostró que la etapa de cuantificación del prolapso de órganos pélvicos previa al tratamiento fue el principal factor pronóstico, seguido de la paridad. No hubo diferencias significativas en el área bajo la curva ROC entre los dos modelos. Conclusión: La paridad, el entrenamiento en casa de la musculatura del suelo pélvico y la etapa de cuantificación del prolapso de órganos pélvicos previa al tratamiento fueron factores pronósticos importantes de la estimulación eléctrica y la terapia de biorretroalimentación en el prolapso posparto de órganos pélvicos.
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Humans , Female , Postpartum Period , Pelvic Organ Prolapse , Biofeedback, Psychology , Electric StimulationABSTRACT
ABSTRACT Background: Anorectal functional pain syndrome, also called chronic proctalgia, represents a neglected clinical entity and often confused with other syndromes such as vulvodynia or acute proctalgia. It is a very often disabling disease with a consequent significant negative impact on the patient's quality of life. Chronic proctalgia, in many patients, is secondary to the paradoxical contraction of the pelvic floor and associated with a dissynergy between the thorax-abdomen and the pelvic floor. To improve symptoms in functional anorectal pain syndromes, various rehabilitation techniques are used with the aim of promoting relaxation of the pelvic floor; however, to improve defecatory dynamics in patients with levator ani syndrome, only biofeedback has shown efficacy in a randomized study. The aim of this work is to evaluate whether a rehabilitation protocol with manometric biofeedback and radiofrequency diathermy (mt100 Fremslife emotion Tecar) reduces pain and paradoxical contraction of the levator ani and improves the quality of life in patients with anorectal pain syndromes. functional. Methods: This was a prospective study on 30 patients (20 women and 10 men) with anorectal functional pain syndrome and paradoxical contraction of the pelvic floor enrolled at the UOC of General, Minimally Invasive, Oncological and Obesity Surgery of the AOU "Luigi Vanvitelli" of Naples, Italy, from September 2021 to May 2022. All patients were evaluated with a coloproctological specialist visit followed by anorectal manometry and evaluation of altered clinical physiatric parameters (Brusciano Score). The protocol consisted of 10 rehabilitation sessions of the pelvic floor once a week and lasting approximately 45 minutes. During the sessions the patients were subjected to diathermy / radiofrequency treatment (10 minutes) with a static resistive electrode on the diaphragm, during which they were required to breathe diaphragmatically and to become aware of the perineal muscles, under the supervision of a physiotherapist; followed by application of diathermy with static capacitive (5 minutes) and resistive (10 minutes) electrode at the lumbar level. This was followed by the use of manometric biofeedback (15 minutes of tonic / phasic exercises) in order to instruct the patient on the reflex mechanism to obtain a voluntary relaxation of the external anal sphincter. The variables evaluated were Pain (VAS 0-10) and the questionnaire on the impact of colorectal and anal pathologies on the quality of life (CRAIQ-7) at the beginning, after 3 months and at the end of the treatment. Results: After 10 weeks, the rehabilitation treatment combined with diathermy and manometric biofeedback proved effective in the short term with a reduction in the scores of the Vas scale and CRAIQ-7 questionnaire and an increase in the percentage of release of the anal muscles on anorectal manometry. Conclusion: The use of radiofrequency diathermy with a system of static electrodes associated with biofeedback represents a valid rehabilitation option for those patients suffering from anorectal functional pain syndrome because it reduces pain and paradoxical contraction of the levator ani and improves quality of life of the patient.
RESUMO Contexto: A síndrome de dor funcional anorretal, também conhecida como proctalgia crônica, representa uma entidade clínica negligenciada e frequentemente confundida com outras síndromes, como vulvodinia ou proctalgia aguda. Trata-se de uma doença frequentemente incapacitante, com um consequente impacto negativo significativo na qualidade de vida do paciente. A proctalgia crônica, em muitos pacientes, é secundária à contração paradoxal do assoalho pélvico e está associada a uma dissinergia entre o tórax-abdômen e o assoalho pélvico. Para melhorar os sintomas em síndromes de dor anorretal funcional, são utilizadas diversas técnicas de reabilitação com o objetivo de promover o relaxamento do assoalho pélvico. No entanto, para melhorar a dinâmica de evacuação em pacientes com síndrome do elevador do ânus, apenas o biofeedback demonstrou eficácia em um estudo randomizado. Objetivo: O objetivo deste trabalho é avaliar se um protocolo de reabilitação com biofeedback manométrico e diatermia por radiofrequência (mt100 Fremslife emotion Tecar) reduz a dor e a contração paradoxal do elevador do ânus e melhora a qualidade de vida em pacientes com síndromes de dor anorretal funcional. Métodos: Realizado estudo prospectivo com 30 pacientes (20 mulheres e 10 homens) com síndrome de dor anorretal funcional e contração paradoxal do assoalho pélvico inscritos na UOC de Cirurgia Geral, Minimamente Invasiva, Oncológica e de Obesidade da AOU "Luigi Vanvitelli" de Nápoles, Itália, de setembro de 2021 a maio de 2022. Todos os pacientes foram avaliados com uma consulta especializada em coloproctologia, seguida de manometria anorretal e avaliação dos parâmetros fisiátricos clínicos alterados (Escore de Brusciano). O protocolo consistiu em 10 sessões de reabilitação do assoalho pélvico, uma vez por semana, com duração aproximada de 45 minutos. Durante as sessões, os pacientes foram submetidos a tratamento de diatermia / radiofrequência (10 minutos) com um eletrodo resistivo estático no diafragma, durante o qual foram solicitados a respirar através do diafragma e a tomar consciência dos músculos perineais, sob a supervisão de um fisioterapeuta; seguido pela aplicação de diatermia com eletrodo capacitivo estático (5 minutos) e resistivo (10 minutos) no nível lombar. Isso foi seguido pelo uso de biofeedback manométrico (15 minutos de exercícios tônicos /fásicos) com o objetivo de instruir o paciente sobre o mecanismo reflexo para obter um relaxamento voluntário do esfíncter anal externo. As variáveis avaliadas foram Dor (EVA 0-10) e o questionário sobre o impacto das patologias colorretais e anais na qualidade de vida (CRAIQ-7) no início, após 3 meses e no final do tratamento. Resultados: Após 10 semanas, o tratamento de reabilitação combinado com diatermia e biofeedback manométrico mostrou-se eficaz a curto prazo, com uma redução nos escores da escala VAS e do questionário CRAIQ-7, e um aumento na porcentagem de relaxamento dos músculos anais na manometria anorretal. Conclusão: O uso de diatermia por radiofrequência com um sistema de eletrodos estáticos associado ao biofeedback representa uma opção de reabilitação válida para pacientes que sofrem com a síndrome de dor anorretal funcional, pois reduz a dor e a contração paradoxal do elevador do ânus, melhorando a qualidade de vida do paciente.
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ObjectiveTo explore the immediate and short-term effects of pressure biofeedback therapy combined with Flexi-bar exercise in the sitting position on chronic non-specific low back pain (CNSLBP). MethodsFrom June to September, 2022, 27 CNSLBP students in Xuzhou Medical University and other universities around were randomly divided into pressure biofeedback unit (PBU) group (n = 9), Flexi-bar group (n = 9) and combined group (n = 9). On the basis of routine rehabilitation guidance, the PBU group accepted pressure biofeedback therapy, the Flexi-bar group accepted active vibration therapy, and the combined group accepted pressure biofeedback therapy and active vibration therapy, for three weeks. They were measured core stability with Stabilizer, lumbar joint repositioning error (LJRE) with iHandy, and bilateral transverse abdominis thickness and multifidus muscle cross-sectional area with ultrasonography; and assessed with Visual Analogue Scale for pain (VAS), Oswestry Disability Index (ODI) before and after treatment; and the core stability were measured immediately after the first treatment. ResultsThe indexes of core stability improved after the first treatment (|t| > 3.000, P < 0.05) in all groups, and improved the most in the combined group (F > 10.909, P < 0.001). All the indexes improved after three weeks of treatment (|t| > 2.604, P < 0.05), except for LJRE in PBU group; and they were the best in the combined group (|F| > 4.061, P < 0.05), except LJRE was not significantly different from the Flexi-bar group (P > 0.05). ConclusionPressure biofeedback therapy combined with Flexi-bar exercise in the sitting position can more effectively improve core stability and core muscles, proprioception, and pain for patients with CNSLBP.
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Objective To explore the effects of warming-yang and tonifying-qi needling combined with electromyographic biofeedback therapy(EMGBFT)on brain image structure,surface myoelectric characteristics and neurotransmitters in patients with stroke rehabilitation.Methods A prospective research method was conducted in which 200 stroke rehabilitation patients admitted to the Third Hospital of Xingtai City from February 2021 to February 2022 were selected as the study subjects.According to the random principle,the patients were divided into a control group and an study group,with 100 cases in each group.Both groups received routine treatment for stroke,while the control group received a combination of EMGBFT.The study group received a combination of warming-yang and tonifying-qi acupuncture based on the control group,and both groups continued to receive treatment for 9 weeks.Observe the clinical efficacy of two groups of patients and compare the differences in National Institutes of Health Stroke Scale(NIHSS)scores,traditional Chinese medicine symptom scores,brain image structures,serum neurotransmitter levels,and surface electromyography levels before and after treatment,and observe the occurrence of adverse reactions.Results The effective rate of treatment in the study group was significantly higher than that in the control group(97.00% vs.87.00%,P<0.05).After treatment,NIHSS score,traditional Chinese medicine symptom score,root-mean-square(RMS)of biceps and triceps,and synergistic contraction rate(SCR)were significantly lower than those before treatment in both groups,and the levels of cerebral blood flow(CBF)in the thalamus and frontal lobe,fractional anisotropy(FA),norepinephrine(NE),5-hydroxytryptamine(5-TH),and dopamine(DA)were significantly higher than those before treatment.After treatment,the NIHSS score(4.18±1.09 vs.6.89±1.54),traditional Chinese medicine symptom score(5.41±1.08 vs.9.46±1.55),and biceps RMS(μV:9.76±3.51 vs.16.36±3.44),triceps brachii RMS(μV:6.79±1.83 vs.10.61±2.87),and SCR[(28.08±8.73)% vs.33.08±9.31)%]were significantly lower than those control group(all P<0.05),the CBF of the thalamus(mL·kg-1·min-1:278.97±86.32 vs.233.63±84.62),and the CBF of the frontal lobe(mL·kg-1·min-1:299.31±75.54 vs.262.81±87.18),FA(0.57±0.18 vs.0.48±0.14),serum 5-HT(ng/L:352.83±38.93 vs.306.71±32.54),NE(ng/L:160.83±17.25 vs.122.81±12.41),DA(μg/L:9.23±0.92 vs.7.36±0.71)were significantly higher than those of the control group(all P<0.05).The incidence of adverse reactions in the study group was significantly lower than that in the control group(3.00% vs.14.00%,P<0.05).Conclusion Based on EMGBFT,the combination of warming-yang and tonifying-qi acupuncture can synergistically improve the clinical symptoms and brain image structure in stroke rehabilitation patients,and increase their serum neurotransmitter levels,with fewer adverse reactions,which is worthy of promotion.
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Objective:To investigate the effect of biofeedback combined with pelvic floor training on stress urinary incontinence in elderly men.Methods:This study was prospective and Patients with urinary incontinence after radical prostatectomy from China Rehabilitation Research Center were enrolled. The patients who could not complete or refused the study, had a history of other urinary diseases, and central nervous system diseases were excluded. Patients were divided by random number table method into 3 groups. They were Kegel training group (Group A)which underwent anus contraction training with each contraction for 5 seconds and a rest interval of 2 seconds. Biofeedback combined with Kegel training group (Group B), which was biofeedback combined with anus contraction training and the biofeedback combined Pilates group (Group C) which received the biofeedback combined Pilates training. In group B and group C, patients were placed in the right lateral position and the surface electrode of the rectal probe was inserted into the anus. The reference electrode was fixed at the adductor muscle of the right thigh. The patient is asked to squeeze the electrode as hard as possible by constricting the anus so that the electromyographic signals produced by constricting the anus are synchronized with those on the computer screen. In the electrical stimulation stage of biofeedback therapy, rhomboid waves with current intensity of 30-50 Hz and pulse width of 300μs were used, and the electrical stimulation intensity was determined by the subtle muscle contraction visible. Each of the three training sessions lasted 45 minutes a day for 8 weeks. 1 hour pad test, daily incontinence times, (International Incontinence Counseling Questionnaire, ICIQ), and Oxford Score Scale were recorded every weekend. The 1-hour pad test, the number of incontinent episodes, ICIQ, Oxford Score scale before and after treatment were compared among the three groups, as well as the differences between the groups.Results:There were no significant differences in age, height, weight, history of diabetes or hypertension before treatment, time from postoperative to training, operation method, retention of nerve tract during surgery, Gleason score, 1-hour pad test, the number of episodes of incontinence, ICIQ and Oxford Grading Scale among the 3 groups. The 1-hour pad test results of group A, B and C were (37.4±7.2), (22.2±4.7) and (18.3±2.4) g, respectively, with statistical significance among the three groups ( P<0.01), and the difference between the three groups and before treatment was statistically significant ( P<0.01). The results of the number of episodes of incontinence in group A, B and C after treatment were (4.6±0.7), (3.4±0.6) and (3.0±0.8), respectively, and the difference among the three groups was statistically significant ( P<0.01), and the difference between the three groups and before treatment was statistically significant ( P<0.01). The results of The ICIQ in group A, B and C after treatment were 12(11, 14), 8(7, 9) and 6(5, 8), respectively, and the differences among the three groups were statistically significant ( P<0.01), and the differences between the three groups were statistically significant compared with before treatment ( P<0.01). The results of Oxford Grading Scale in group A, B and C after treatment were 3(3, 3), 4(3, 4) and 4(4, 4), respectively, and the difference between the three groups was statistically significant ( P<0.01), and the difference between the three groups was statistically significant compared with before treatment ( P<0.01). Conclusions:Biofeedback combined with pelvic floor training and biofeedback combined with Pilates training can improve urinary control, pelvic floor muscle strength, and stress urinary incontinence symptoms in male patients with stress urinary incontinence.
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Objective:To explore the effect of combining extracorporeal shockwave therapy (ESWT) with electromyographic biofeedback on the motor functioning of children with spastic cerebral palsy.Methods:Fifty children with spastic cerebral palsy (2-7 years old) were randomized into a control group and an experimental group, each of 25. Both groups received routine rehabilitation and electric stimulation therapy with electromyographic biofeedback, while the experimental group was additionally provided with ESWT. Before and after 8 weeks of treatment, integral electromyograms were recorded and the root mean square values of the electromyogram recorded from the tibialis anterior muscle were computed. Lower limb spasticity and motor ability were evaluated by using the Modified Ashworth Scale (MAS), the Modified Tardieu Scale (MTS), and the D and E regions of the Gross Motor Function Measurement Scale (GMFM-88).Results:After the treatment the results of both groups had improved significantly in terms of the surface electromyography of the tibialis anterior muscle, MAS scores, R1 in the MTS and the difference between R2 and R1, and the GMFM-88 regional scores. All of the improvements were significantly greater in the experimental group than in the control group, on average.Conclusions:Combining ESWT with EMG biofeedback can better relieve lower limb spasticity and improve the motor functioning of children with spastic cerebral palsy.
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Objective:To observe any effect of combining surface electromyography biofeedback with intensive pharyngeal ascending e-biofeedback training on dysphagia among stroke survivors.Methods:Sixty stroke survivors with dysphagia were randomly divided into a biofeedback group, a pharyngeal ascending group and a combination group, each of 20. In addition to routine swallowing training, the biofeedback group received 20 minutes of surface electromyographic biofeedback training daily while the pharyngeal ascending group did pharyngeal rising reinforcement training based on biofeedback for strength and skill training (BiSSkiT) theory. The combination group was given both. Before and after 4 weeks of the interventions, videofluoroscopy was used to evaluate everyone′s swallowing. The Swallowing Function Assessment Scale (SSA) and the Dysphagia Outcome and Severity Scale (DOSS) were also applied.Results:Significant improvement was observed in all 3 groups in terms of their average VFSS, SSA and DOSS scores. The average videofluoroscopy, SSA and DOSS results of the combination group were then significantly better than the other two groups′ averages, and those of the pharyngeal ascending group were significantly superior to those of the biofeedback group.Conclusion:Combining intensive pharyngeal ascending electronic biofeedback training with surface EMG biofeedback can significantly improve the swallowing function of stroke survivors.
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Objective:To analyze the effects of pelvic floor muscle biofeedback electrical stimulation (PEMS) combined with pelvic floor muscle training (PFMT) and PFMT alone on mild to moderate stress urinary incontinence (SUI) after delivery.Methods:This retrospective study involved 1 087 postpartum women with mild or moderate SUI who were admitted to the Affiliated Hospital of Jining Medical University from January 2017 to January 2021. According to the treatment approaches, they were divided into two groups: the PMES+PFMT group ( n=504) and the PFMT group ( n=583). Chi-square test, independent sample t-test and rank sum test were used to compare the objective indicators (pelvic floor muscle strength test, vaginal dynamic pressure value test, 1-h pad test) and subjective indicators [incontinence impact questionnaire short form (IIQ-7), incontinence questionnaire-urinary incontinence short form (ICI-Q-SF), pelvic organ prolapse/urinary incontinence sexual function questionnaire (PISQ-12)] before, immediate and three months after treatment between the two groups. Results:There was no significant difference between the two groups in the values of vaginal dynamic pressure before treatment, 1-h pad test results and subjective indicators (all P>0.05). Comparison within groups: Indicators were improved in both groups immediate and three months after treatment compared with before treatment, including strength of type Ⅰ muscle [PMES+PFMT group: grade 4 and 5 (normal): 43.5% (219/504) and 42.1% (212/504) vs 1.2% (6/504), χ 2=864.27 and 861.46; PFMT group: grade 4 and 5:19.2% (112/583) and 20.1% (117/583) vs 1.5% (9/583), χ 2=1 148.26 and 1 038.29] and class Ⅱ muscle strength [PMES+PFMT group: 48.4% (244/504) and 50.8% (256/504) vs 4.8% (24/504), χ 2=862.96 and 819.24; PFMT group: 37.4% (218/583) and 38.9% (227/583) vs 5.0% (29/583), χ 2=1 029.47 and 998.54; all P < 0.05].Vaginal dynamic pressure increased [PMES+PFMT group: (89.3±5.4) and (82.2±4.6) vs (67.5±12.7) cmH 2O (1 cmH 2O=0.098 kPa), t=802.13 and 845.54; PFMT group:(80.2±4.3) and (78.6±4.5) vs (66.9±14.2) cmH 2O, t=288.37 and 244.94], and 1-hour urine leakage reduced [PMES+PFMT group: 2.0 g (2.0-3.0 g) and 2.0 g (1.0-3.0 g) vs 6.0 g (5.0-6.0 g), Z=825.39 and 802.13; PFMT group: 4.0 g (3.0-5.0 g) and 3.0 g (3.0-4.0 g) vs 5.0 g (4.0-6.0 g), Z=836.34 and 811.25], and IIQ-7 scores [PMES+PFMT group: scores of 3 (2-4) and 4 (3-4) vs 8 (7-9), Z=959.52 and 825.87; PFMT group: 5 (4-5) and 5 (4-6) vs 8 (7-10), Z=916.27 and 903.18], and ICI-Q-SF score [PMES+PFMT group: 3.5 (3-4) and 4 (3-5) vs 10 (9-12), Z=952.79 and 924.94; PFMT group: 6 (4-7) and 6 (5-7) vs 11 (10-12), Z=1 049.89 and 998.15], and PISQ-12 score [PMES+PFMT group: 10 (7-12) and 9 (7-12) vs 21 (17-24), Z=862.55 and 887.17; PFMT group: 13 (11-16) and 14 (12-16) vs 22 (18-25), Z=1 026.73 and 934.86, all P<0.05) decreased. Compared with the PFMT group, the above indexes were all better in the PMES+PFMT group (all P<0.05). Conclusion:PFMT alone or in combination with PMES can both enhance pelvic floor muscle strength, increase vaginal dynamic pressure, alleviate urine leakage and improve the quality of life and PMES+PFMT is better and more effective.
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Resumo Objetivo Avaliar o efeito do Biofeedback cardiovascular sobre os níveis de coping dos profissionais da enfermagem de um hospital universitário, quando comparado com uma atividade informatizada sem automonitoramento. Métodos Ensaio clínico randomizado, com dois grupos, Biofeedback e placebo, realizado com 115 profissionais de enfermagem de um hospital universitário. Os grupos participaram de nove encontros por três semanas. O desfecho foi avaliado pelo Inventário de Respostas de Coping no Trabalho, versão brasileira, aplicado prévio a primeira sessão e imediatamente após a sessão final. A análise do desfecho foi feita pela ANCOVA , considerando α = 5%. Resultados A variação das Respostas de Enfrentamento apresentou efeito estatisticamente significativo, o grupo controle apresentou aumento de 0,17 pontos nesta variação quando comparado ao grupo intervenção ( h 2 = 0,07; p=0,004). A variação das Respostas de Evitação e do Nível Geral de Coping não evidenciou efeito estatisticamente significativo na interação grupo/tempo (respectivamente, p=0,471 e p=0,786). Conclusão A intervenção com Biofeedback cardiovascular demonstrou não ter efeito superior ao placebo na melhora dos níveis de coping .
Resumen Objetivo Evaluar el efecto del Biofeedback cardiovascular sobre los niveles de coping de los profesionales de enfermería de un hospital universitario, en comparación con una actividad informatizada sin automonitoreo. Métodos Ensayo clínico aleatorizado, con dos grupos, Biofeedback y placebo, realizado con 115 profesionales de enfermería de un hospital universitario. Los grupos participaron en nueve encuentros durante tres semanas. El desenlace fue evaluado por el Inventario de Respuestas de Coping en el Trabajo, versión brasileña, aplicado antes de la primera sesión e inmediatamente después de la sesión final. El análisis del desenlace se realizó por ANCOVA , considerando α = 5 %. Resultados La variación en las Respuestas de Afrontamiento presentó un efecto estadísticamente significativo. El grupo control presentó un aumento de 0,17 puntos en esta variación al compararlo con el grupo experimental ( h 2 = 0,07; p=0,004). La variación de las Respuestas de Evitación y del Nivel General de Coping no evidenció un efecto estadísticamente significativo en la interacción grupo/tiempo (respectivamente, p=0,471 y p=0,786). Conclusión La intervención con Biofeedback cardiovascular demostró que no tiene efecto superior al del placebo en la mejora en los niveles de coping .Registro do Clinical Trial: NCT04446689
Abstract Objective To assess the effect of cardiovascular biofeedback on coping levels of nursing professionals at a university hospital, when compared with a computerized activity without self-monitoring. Methods This is a randomized clinical trial, with two groups, biofeedback and placebo, carried out with 115 nursing professionals from a university hospital. The groups participated in nine meetings for three weeks. The outcome was assessed by Coping Responses Inventory, Brazilian version, applied prior to the first session and immediately after the final session. The outcome analysis was performed by ANCOVA, considering α = 5%. Results The Coping Responses variation had a statistically significant effect. The control group showed an increase of 0.17 points in this variation when compared to the intervention group (h 2 = 0.07; p=0.004). The Avoidance Responses variation and Overall Coping Level did not show a statistically significant effect on the group/time interaction (p=0.471 and p=0.786, respectively). Conclusion Intervention with cardiovascular biofeedback was shown to have no superior effect than placebo in improving coping levels.Clinical Trial Record: NCT04446689
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ABSTRACT Objective: to assess the effect of cardiovascular biofeedback on nursing staff stress when compared to an activity without self-monitoring. Method: a randomized controlled clinical trial, carried out with nursing professionals from a university hospital. The intervention group (n=58) performed cardiovascular biofeedback, and the control (n=57) performed an online puzzle without self-monitoring, totaling nine meetings over three weeks. The outcome was assessed using the Stress Symptoms and Work-Related Stress scales, and the biological marker heart rate variability. The generalized estimating equations method was used. Results: the intervention had no effect on self-reported instruments (p>0.050). However, there was an effect of time (p<0.050) on all heart rate variability indicators, demonstrating changes over the sessions. Conclusion: cardiovascular biofeedback showed promising results in the biological marker, suggesting that it can be used in nursing staff as a complementary therapy by promoting better autonomic nervous system regulation.
RESUMEN Objetivo: evaluar el efecto del biofeedback cardiovascular sobre el estrés del equipo de enfermería cuando se compara con una actividad sin autocontrol. Método: ensayo clínico controlado aleatorizado, realizado con profesionales de enfermería de un hospital universitario. El grupo de intervención (n=58) realizó biorretroalimentación cardiovascular, y el control (n=57) realizó un rompecabezas en línea sin autocontrol, totalizando nueve reuniones durante tres semanas. El resultado se evaluó mediante las escalas Síntomas de Estrés y Estrés en el Trabajo, y el marcador biológico de variabilidad de la frecuencia cardiaca. Se analizó utilizando el método Generalizado de Ecuaciones de Estimación. Resultados: la intervención no tuvo efecto en los instrumentos autoinformados (p>0,050). Sin embargo, hubo un efecto del tiempo (p<0,050) en todos los indicadores de variabilidad de la frecuencia cardíaca, demostrando cambios a lo largo de las sesiones. Conclusión: el biofeedback cardiovascular mostró resultados promisorios en el marcador biológico, sugiriendo que puede ser utilizado en el equipo de enfermería como terapia complementaria al promover una mejor regulación del Sistema Nervioso Autonómico.
RESUMO Objetivo: avaliar o efeito do biofeedback cardiovascular no estresse da equipe de enfermagem quando comparado a uma atividade sem automonitoramento. Método: ensaio clínico controlado aleatório, realizado com profissionais de enfermagem de um hospital universitário. O grupo intervenção (n=58) realizou biofeedback cardiovascular, e o controle (n=57) fez um quebra-cabeça online sem automonitoramento, totalizando nove encontros durante três semanas. O desfecho foi avaliado pelas escalas Sintomas de Estresse e Estresse no Trabalho, e pelo marcador biológico variabilidade da frequência cardíaca. Utilizou-se com o método Equações de Estimativas Generalizadas. Resultados: a intervenção não apresentou efeito nos instrumentos autorreferidos (p>0,050). Entretanto, houve efeito de tempo (p<0,050) em todos os indicadores da variabilidade da frequência cardíaca, demonstrando modificação ao longo das sessões. Conclusão: o biofeedback cardiovascular apresentou resultados promissores no marcador biológico, sugerindo que poderá ser utilizado na equipe de enfermagem como terapia complementar por promover melhor regulação do Sistema Nervoso Autônomo.
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Objetivo: Compreender como os diversos tipos de biofeedback agem, e se são eficazes no controle do bruxismo do sono e vigília. Métodos: trata-se de uma revisão de escopo, com busca em três bases de dados, Medline (Pubmed e BVS), PEDRo e Cochrane, e redigida de acordo com as diretrizes do PRISMA-ScR. Resultados: Foram encontradas 595 referências. Após a remoção das duplicatas e da aplicação dos critérios de elegibilidade, trinta e cinco artigos foram incluídos. A maioria investigou o bruxismo do sono e o uso de placas orais integradas a sistemas de biofeedback, principalmente através de estímulos exteroceptivos. Na maioria dos artigos, o biofeedback foi efetivo a curto prazo para o bruxismo do sono, reduzindo a duração dos episódios, mas não alterando o número de episódios do bruxismo, mas com retorno aos níveis do pré-tratamento. O uso do biofeedback foi mais efetivo para o bruxismo de vigília e nos estudos que investigaram ambos os tipos de bruxismo, mas, com o uso do biofeedback apenas no período diurno, foi possível observar uma redução tanto nos eventos do bruxismo de vigília como nos do sono. Conclusão: A maioria das pesquisas se utilizou do biofeedback por meio de estímulo exteroceptivo, com reforço negativo a um estímulo aversivo; poucos estudos utilizaram o biofeedback com o propósito de condicionamento motor ou de mudança comportamental, sendo esses mais eficazes, mesmo após a retirada do estímulo.
Aim:To comprehend the functioning of various biofeedback types and their effectiveness in controlling sleep and awake bruxism. Methods: This is a scoping review, conducted in three databases: Medline (Pubmed and VHL), PEDRo, and Cochrane, and was written according to PRISMA-ScR guidelines. Results: Our study found 595 references; after removing duplicates and applying the eligibility criteria, thirty-five articles were included. Most studies examined the effectiveness of biofeedback systems that integrated oral splints, primarily through the use of exteroceptive stimuli, to manage sleep bruxism. Although biofeedback was found to reduce the duration of bruxism episodes in the short term in most articles, it did not significantly change the number of episodes, which reverted to pre-treatment levels. The use of biofeedback was more effective for awake bruxism. Moreover, in the studies that investigated both types of bruxism, but with the use of biofeedback only during the day, it was possible to observe a reduction in both the events of awake and sleep bruxism. Conclusion: Most studies used biofeedback with negative reinforcement through exteroceptive stimulation to an aversive stimulus. Few studies use biofeedback for motor conditioning or behavioral change. The latter approaches proved to be more effective, even after discontinuing the stimulus.
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Biofeedback, Psychology , Bruxism , Sleep BruxismABSTRACT
Abstract Background Parkinson disease (PD) is a progressive condition that causes disorders in movement and balance. Objective To evaluate the effectiveness of static posturography-assisted biofeedback exercises in PD-related balance disorder. Methods We screened 83 patients, 48 of whom were enrolled, and 41 completed the study. The sample was randomized into two groups, one submitted to static posturography-assisted biofeedback exercises and the other, to a conventional exercise program. The patients in the biofeedback group (n =20) performed biofeedback exercises in addition to conventional balance exercises. Those in the conventional exercise group (n = 21) performed classic balance exercises. Both groups were treated for 20 minutes per session 3 times a week for 6 weeks. The patients were evaluated using the Hoehn and Yahr Scale, the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS), the Berg Balance Scale (BBS), the Tinetti Gait and Balance Assessment (TGBA), the Timed Up and GoTest (TUG), the Tandem Stance Test (TST), a Turkish version of the Stanford Health Assessment Questionnaire (HAQ), and the Beck Depression Inventory (BDI) before and at the end of the treatment. Results No statistically significant differences were observed between the two groups in terms of the MDS-UPDRS, BBS, TGBA, TST, TUG, HAQ, or BDI measurements before and after the treatment (p > 0.05). Conclusions Improved balance parameters were observed following balance training in the patients with PD, although static posturography-assisted biofeedback exercises appeared to provide no additional benefit. However, larger, randomized controlled trials are needed to investigate their effectiveness.
Resumo Antecedentes A doença de Parkinson (DP) é uma doença degenerativa que causa alterações no movimento e no equilíbrio. Objetivo Avaliar a eficácia dos exercícios com biorretroalimentação assistidos por posturografia estática na alterações do equilíbrio derivadas da DP. Métodos Selecionamos 83 pacientes, 48 dos quais foram incluídos, e 41 completaram o estudo. A amostra foi randomizada e dividida em dois grupos, um submetido a exercícios com biorretroalimentação assistidos por posturografia estática, e outro submetido a um programa de exercícios convencional. Os pacientes do grupo de biorretroalimentação (n = 20) fizeram exercícios com biorretroalimentação e exercícios convencionais de equilíbrio. E o grupo dos exercícios convencionais (n = 21), fez exercícios clássicos de equilíbrio. Ambos os grupos receberam tratamento durante 20 minutos por sessão, 3 vezes por semana, por 6 semanas. Os pacientes foram avaliados antes e depois do tratamento pela Escala de Hoehn e Yahr, Escala Unificada de Avaliação da Doença de Parkinson (EUADP) da Movement Disorder Society (MDS), a Escala de Equilíbrio Berg (EEB), Avaliação de Equilíbrio e Marcha Tinetti (AEMT), oTeste Timed Up and Go (TUG), o Teste de Apoio Tandem (TAT), a versão em turco do Questionário de Avaliação de Saúde (QAS) de Stanford, e o Inventário de Depressão de Beck (IDB). Resultados Não se observaram diferenças estatisticamente significativas entre os dois grupos quanto às mediçõesdo EUADP, EEB, AEMT, TAT, TUG, QAS ou IDB realizadas antes e depois do tratamento (p > 0.05). Conclusões Verificou-se uma melhoria dos parâmetros de equilíbrio após os exercícios de equilíbrio nos pacientes com DP, apesar de não ter sido detectado sem nenhum benefício adicional aparente dos exercícios com retroalimentação assistidos por posturografia estática. Contudo, é necessário efetuar ensaios maiores, randomizados e controlados para estudar a sua eficácia.
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Introducción. El cáncer de próstata es la neoplasia más frecuente en hombres. La prostatectomía radical es el tratamiento de elección para el cáncer de próstata localizado. Una de las complicaciones más frecuentes de este tipo de cirugía es la incontinencia urinaria, la que impacta negativamente en la calidad de vida de los pacientes. El biofeedback es una de las intervenciones terapéuticas que forman parte del tratamiento conservador de primera línea para la incontinencia urinaria post prostatectomía, sin embargo, no existe consenso sobre su protocolo de aplicación. Objetivo. Conocer la evidencia disponible sobre el uso del biofeedback en el tratamiento de la Incontinencia Urinaria en pacientes post prostatectomía. Métodos. Se realizó una búsqueda bibliográfica en las bases de Datos: Science Direct:,Mendeley, Medline, Pubmed, Epistemonikos, Ibecs, Lilacs y Scielo. Se obtuvo un total de 172 artículos, de los cuales 12 cumplieron con los criterios de inclusión y exclusión siendo seleccionados para la síntesis cualitativa. Resultados. Los 12 artículos seleccionados tienen una amplia variabilidad en los protocolos de aplicación del biofeedback. Las principales intervenciones para el tratamiento de la incontinencia urinaria post prostatectomía radical, efectuados en estos estudios, son el entrenamiento muscular de piso pélvico con biofeedback y/o electroestimulación. La mayor efectividad terapéutica con BFB se obtuvo en los estudios que combinan EMPP, BFB y EE. Conclusión. El uso de biofeedback en el tratamiento de la incontinencia urinaria post prostatectomía presenta amplia variabilidad en los protocolos de aplicación. La mayor efectividad se obtiene en terapias combinadas.
Background. Prostate cancer is the most frequent neoplasm in men. Radical prostatectomy is the treatment of choice for localized prostate cancer. One of the most frequent complications of this type of surgery is urinary incontinence, which has a negative impact on the quality of life of patients. Biofeedback is one of the therapeutic interventions that are part of the first-line conservative treatment for post-prostatectomy urinary incontinence; however, there is no consensus on its application protocol. Objective. To know the available evidence on the use of biofeedback in the treatment of urinary incontinence in post prostatectomy patients. Methods. A bibliographic search was carried out in the following databases: Science Direct, Mendeley, Medline, Pubmed, Epistemonikos, Ibecs, Lilacs and Scielo. A total of 172 articles were obtained, of which 12 fulfilled the inclusion and exclusion criteria and were selected for qualitative synthesis. Results. The 12 selected articles have a wide variability in the biofeedback application protocols. The main interventions for the treatment of urinary incontinence after radical prostatectomy, performed in these studies, are pelvic floor muscle training with biofeedback and/or electrostimulation. The greatest therapeutic effectiveness with BFB was obtained in the studies combining PFMT, BFB and ES. Conclusion. The use of biofeedback in the treatment of post-prostatectomy urinary incontinence presents a wide variability in the application protocols.
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Introducción. El cáncer de próstata es una patología con alta prevalencia, la prostatectomía radical es la técnica quirúrgica utilizada y la disfunción eréctil es una de las secuelas más frecuentes de ésta. En la actualidad existen diferentes intervenciones en el manejo de la disfunción eréctil. La literatura refiere como tratamiento de primera línea el uso de inhibidores de la fosfodiesterasa-5, también se describe que el uso de terapia física podría potenciar la mejora de la disfunción eréctil en conjunto con el tratamiento farmacológico. Objetivo. Identificar y describir la evidencia científica disponible referente a la efectividad de la terapia física en pacientes con disfunción eréctil posterior a una prostatectomía. Métodos. Se realizó una búsqueda en Pubmed, LILACS, Cochrane Library, de artículos publicados entre el 2012 y 2022. Se seleccionaron los relacionados con los efectos de la terapia física en la disfunción eréctil posterior a prostatectomía Resultados: En esta revisión se incluyeron 9 estudios. La mayoría demostró mejoras en la disfunción eréctil con la aplicación de la terapia de ondas de choque extracorpóreas de baja intensidad y entrenamiento muscular de piso pélvico, combinada con el tratamiento farmacológico. Conclusión. Debido a la alta prevalencia de la disfunción eréctil posterior a prostatectomía radical y a la escasa evidencia existente, se sugieren más investigaciones en el área, con diseños metodológicamente rigurosos, que incluyan un mayor tamaño de muestra y profundicen en la creación protocolos de rehabilitación y su posterior seguimiento.
Background. Prostate cancer is a pathology with high prevalence, radical prostatectomy is the surgical technique used and erectile dysfunction is one of the most frequent sequelae of this. Currently there are different interventions in the management of erectile dysfunction. The literature refers as first line treatment the use of phosphodiesterase-5 inhibitors, it is also described that the use of physical therapy could enhance the improvement of erectile dysfunction in conjunction with pharmacological treatment. Objective. To identify and describe the available scientific evidence regarding the effectiveness of physical therapy in patients with erectile dysfunction following prostatectomy. Methods. A search was performed in Pubmed, LILACS, Cochrane Library, of articles published between 2012 and 2022. Those related to the effects of physical therapy on post-prostatectomy erectile dysfunction were selected Results. 9 studies were included in this review. Most demonstrated improvements in erectile dysfunction with the application of low-intensity extracorporeal shock wave therapy and pelvic floor muscle training combined with pharmacological treatment. Conclusion. Due to the high prevalence of erectile dysfunction after radical prostatectomy and the scarce existing evidence, more research is suggested in this area, with methodologically rigorous designs, including a larger sample size and deepening in the creation of rehabilitation protocols and their subsequent follow-up.
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Background: Aging is a gradual, life-long process and highly variable, characterized by a progressive and cumulative generalized impairment of physiological functions which in turn reduces functional performance and disturbs ADL's & may lead to significant impact on core & lower limb muscles, which are important in functioning. Thus, the study aimed at assessing correlation amongst the core & lower limb muscles and functional status. Methods and procedures: 84 participants between 70-79 years of age (Male:Female = 1:1) were assessed for core strength, Lower limb strength and functional mobility using pressure biofeedback, five times sit to stand and timed up and go test respectively and data was tabulated & analyzed further in SPSS. Results: Spearman's correlation was used in this study which showed significant positive correlation between core strength and lower limb strength with lower limb functional status. (r(Core)=0.813, r(5SST) =0.893; p(Core)=0.00, p(5SST) =0.00) Discussion: Optimal core stability helps maintain the center of gravity within the altered base of support and this could be a reason for individuals with good core strength having better functional mobility. Also force of muscle contraction is directly proportional to velocity of movement which is seen reduced in lower limb musculature because of aging in this population. Conclusion: The present study concluded that strong correlation of core strength and lower limb strength with functional mobility exists among middle old elderly population.