FUNCTIONAL DIAGNOSTICS GASTROINTESTINAL What is Biofeedback? q Provides the patient immediate...
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Transcript of FUNCTIONAL DIAGNOSTICS GASTROINTESTINAL What is Biofeedback? q Provides the patient immediate...
FUNCTIONAL DIAGNOSTICSGASTROINTESTINAL
What is Biofeedback?What is Biofeedback?
Provides the patient immediate Auditory and/or Visual information about Physiological Process
It's a Therapy, i.e. type of treatment where people are trained to improve their health by using Signals from their own bodies
By watching the monitor and listening to the sound the patient gets the Feedback information and can adjust thinking and behavior .
The Goal in Lower GI is to Improve Improve Pelvic Floor Dysfunction by teaching patients to change physiologic responses
FUNCTIONAL DIAGNOSTICSGASTROINTESTINAL
Biofeedback in Lower GI Biofeedback in Lower GI
SphincterEMG
AbdominalPressure
Voluntary Sphincter contractions are recorded. Abdominal pressure as well
Feedback sent to patient (display and/or sound)
Patient actions:
To increase sphincter contraction
To decrease abdominal pressureMotor
Internal Sphincter
S2S3S4
External Sphincter
Efferent
FUNCTIONAL DIAGNOSTICSGASTROINTESTINAL
Pelvic Floor Training EMG + PressurePelvic Floor Training EMG + Pressure
EMGUraVagAnal
Pabd
5" 7" 4" 18"Duration Increased
Effort
Straining
EMG curve area
=
Effort Index
FUNCTIONAL DIAGNOSTICSGASTROINTESTINAL
Patient Selection ProcessPatient Selection Process
Evaluate patient - diagnostic tests: AFT/ others
Diagnose patient Incontinence Constipation Others
Evaluate whether this patient would benefit from Biofeedback
FUNCTIONAL DIAGNOSTICSGASTROINTESTINAL
PathologiesPathologies
Incontinence
Stress Fecal Incontinence due to:
Weak external Sphincter
Dyssynergia IS/ES to Rectum
Pelvic Floor Muscles Dysfunction
Constipation Due to Anismus
Non-Neurogenic Origin
FUNCTIONAL DIAGNOSTICSGASTROINTESTINAL
Biofeedback ProcessBiofeedback 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
Etc...
FUNCTIONAL DIAGNOSTICSGASTROINTESTINAL
Sprite moves up/ down according to patient activity
Lane moves right to left
Patient tries to follow the lane
Lane
Sprite
Polygraf ID® ConceptPolygraf ID® Concept
FUNCTIONAL DIAGNOSTICSGASTROINTESTINAL
Protocol SettingsProtocol Settings
Primary (and secondary) channel
Capture display rate
Lane (Squeeze, Relax)
Initial wait Time response Duration
Target level
Tolerance
Number of repetitions
Graphics for lane, above lane,
below lane and sprite (BMP files)
Sound (wave file)
Amplitude
Time
Squeeze
Time response
FUNCTIONAL DIAGNOSTICSGASTROINTESTINAL
Running BiofeedbackRunning Biofeedback
Run non-saving mode
“Monitoring/ Set-up phase”
Change of protocol must be done before you enter saving mode
Run saving mode 1 or more recordings (training paradigms)
FUNCTIONAL DIAGNOSTICSGASTROINTESTINAL
Reviewing BiofeedbackReviewing Biofeedback
ReviewLane displayed
“Hidden” markers - bar
Calculations (mouse over)
ReportProtocol used
Fulfillment in percent
(percentage time within lane)
Relax, squeeze, total
FUNCTIONAL DIAGNOSTICSGASTROINTESTINAL
Polygraf ID
With Polygraf ID®With Polygraf ID®
Various background screens are available
Curves analysis to quantify training and improvement
FUNCTIONAL DIAGNOSTICSGASTROINTESTINAL
Pelvic Floor Training EMG + PressurePelvic Floor Training EMG + Pressure
Anal Sphincter and
Abdominal Pressureactivity
I try to Contract or relaxContract or relax my SphinctersSphincters and keep my
AbdominalAbdominal WallWall Relaxed !Relaxed !
FUNCTIONAL DIAGNOSTICSGASTROINTESTINAL
Pelvic Floor Training Two EMGPelvic Floor Training Two EMG
Sphincter orVaginal EMG
and Suprapubic EMG
FUNCTIONAL DIAGNOSTICSGASTROINTESTINAL
AccessoriesAccessories
Pressure Measurement
1. DPT Pressure Transducer With extension line & flushing syringe
2. Abdominal Catheter a. Opened-end - F8 b. Balloon
1
2a
2b
9021P1091
9021P4221
1. Disposable Surface
3. Reusable Anal Plug With Abdominal catheter insertion lumen
2. Disposable Anal and Vaginal Sponge
1
2
3
EMG Electrodes
9013K07829013K0792
9013L48119021L0203
9021S02319013S0221
FUNCTIONAL DIAGNOSTICSGASTROINTESTINAL
Polygram Net Biofeedback ApplicationPolygram Net Biofeedback Application
Enhancement wishes with the migration:
A count-down window showing performed/to go procedures (in capture)
Fine tuning of the track directly from the education view - by moving the lane/track to the
patients performance level
Progress report that evaluate the patients
improvements over time.
FUNCTIONAL DIAGNOSTICSGASTROINTESTINAL
FUNCTIONAL DIAGNOSTICS
Thanks!Thanks!