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

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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

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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 !