FUNCTIONAL DIAGNOSTICSGASTROINTESTINAL
FUNCTIONAL DIAGNOSTICS
BiofeedbackBiofeedback
Copyright MFD 2001 - Any kind of reproduction is prohibitedCopyright MFD 2001 - Any kind of reproduction is prohibited
FUNCTIONAL DIAGNOSTICSGASTROINTESTINAL
Biofeedback 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
BiofeedbackBiofeedback
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
information and he can adjust his thinking and behavior .
The Goal is to Improve Improve Pelvic Floor FFunction by teaching patients to change physiologic responses
Motor
Anal kanalAnal kanalS2S3S4
Descending
FUNCTIONAL DIAGNOSTICSGASTROINTESTINAL
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
FUNCTIONAL DIAGNOSTICSGASTROINTESTINAL
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)
FUNCTIONAL DIAGNOSTICSGASTROINTESTINAL
PathologiesPathologies
Incontinence
Stress Fecal Incontinence Weak external Sphincter Dyssynergia IS/ES to Rectum Pelvic Floor Muscles Dysfunction
Constipation Due to Anismus
Non-Neurogenic Origin
FUNCTIONAL DIAGNOSTICSGASTROINTESTINAL
Polygraf ID
With Polygraf ID®
Various background screens are available
Curves analysis to quantify training and improvement
FUNCTIONAL DIAGNOSTICSGASTROINTESTINAL
Biofeedback
Marketing package; Product flyer Summaries of reference
articles Sample reports Example Data Export
files
Training program
FUNCTIONAL DIAGNOSTICSGASTROINTESTINAL
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)
1 2 3
54
FUNCTIONAL DIAGNOSTICSGASTROINTESTINAL
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
FUNCTIONAL DIAGNOSTICSGASTROINTESTINAL
Pelvic Floor Training constipationPelvic Floor Training constipation
I try to Contract or relaxContract or relax my SphinctersSphincters and keep my
AbdominalAbdominal WallWall Relaxed !Relaxed !
Sphincter and
Abdominal Muscle activity
SPHINCTER
ABDOMINAL
FUNCTIONAL DIAGNOSTICSGASTROINTESTINAL
EMG measurements in general
What is measured? Muscle electrical activity over a bundle of muscle
fibers
FUNCTIONAL DIAGNOSTICSGASTROINTESTINAL
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
FUNCTIONAL DIAGNOSTICSGASTROINTESTINAL
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
FUNCTIONAL DIAGNOSTICSGASTROINTESTINAL
Reviewing BiofeedbackReviewing Biofeedback
Review Lane displayed
“Hidden” markers - bar
Calculations (mouse over)
ReportProtocol used
Fulfillment in percent
(percentage time within lane)
Relax, squeeze, total
FUNCTIONAL DIAGNOSTICSGASTROINTESTINAL
Accessories
1. Disposable Surface
3. Reusable Anal Sphincter With Abdominal catheter insertion lumen
2. Disposable Anal and Vaginal
1
2
3
EMG Electrodes Pressure Catheters
Anorectal
FUNCTIONAL DIAGNOSTICSGASTROINTESTINAL
FUNCTIONAL DIAGNOSTICS
Thanks !Thanks !
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