18 de Junho de 2012

Repetitive Strain Injuries - Analysis of risk factors

Improper work habits, poor workstation ergonomics and environment can lead to physiological disorders such as muscle weakness, fatigue and injury. Some workers develop repetitive strain injury (RSI), also known as cumulative trauma stress (TEC), or on the use syndrome due to long hours of repetitive tasks on computers. Workers with RSI suffer from loss of productivity gains and decreased with increasing medical costs. The RSI has reached 40% of cases of reimbursement of medical expenses in the U.S. in 1990. The discomfort and injury can change the way computer users feel about these and their work. 40 million Americans use computers and 15-20% of those at risk of developing symptoms of RSI (CDC, 1984). RSIs tend to afflict people with diseases and overburden businesses with increasing medical costs and lost productivity. Indeed, analysis of ergonomic workstation, proper positioning of furniture and equipment, and different keyboards and mice periodic rest may help in reducing the physiological problems, however, lacks two crucial elements: * Attention kinesthetic user's computer psychophysiology and * Developing skills to inhibit inappropriate voltages and / or excessive during task performance. Computer users must learn to reduce tension and relax muscles when they are not being used for the task. Preventing RSI involves a combination of proper ergonomics, variation in work activities (work / rest cycle) and self-regulation through biofeedback to reduce harmful activities (improper muscle tension, misguided or even unconscious). Without attention to the muscular effort and without the skills training to reduce stress, ergonomic adjustments with intermittent rest periods are not sufficient to prevent the risk of injury.

Computer users can learn preventative skills to feel the muscle tension and incorporate relaxation and regeneration of muscles during typing and mouse use. Biofeedback instruments can be used to monitor specific muscles and alert the user to the existence of tensions or excessive use of super habits that can lead to chronic pain and injury. This process mastery reduces the risk of occurrence of RSI.



The development of RSI involves ergonomic and psychophysiological contributing factors that include:    

  • Ergonomics inappropriate workstation    

  • Stress near vision (monitor)    

  • Asymmetrical task performance    

  • Body movements restricted    

  • Absence of regenerative brief pauses (1-2 seconds) at work (micro breaks)    

  • Poor posture at work (contraction, lack of inhibition of antagonist during movement)    

  • Lack of somatic awareness of tension and relaxation    

  • Physiological stress during self-induced relaxation    

  • Excessive focus on tasks    

  • Dissatisfaction with work    

  • Excessive physiological reactivity    

  • Thoracic breathing and / or breath while typing    

  • Presence of points of tension of the tendons    

  • RSI protocol includes ergonomic assessments and work style, psychophysiological profile, analysis of risk factors, training and education in biofeedback.



Biofeedback techniques for treating urinary incontinence

Biofeedback Technique for Pelvic Muscle exercises.

The biofeedback to treat urinary incontinence was pioneered by Arnold Kegel in 40 years. Muscle contraction exercises performed without EMG monitoring can lead to contractions of other muscles such as abdominals, buttocks and thighs, thus leading to fatigue and severe pressure on the bladder. Several investigators have reported that monitoring of the pelvic floor muscles by surface electrodes captured muscle activity highly correlated with those obtained using needle electrode inserted directly into the pelvic muscles. Treatment of surface EMG have been shown to be highly effective 3,7,12,19. The home training with biofeedback demonstrated to promote significant improvements in symptom reduction and elimination of urinary incontinence compared with Kegel exercises, done alone or together with a resistive equipment.

Figure : Longitudinal electrodes (A or V) of inserted sensors are much closer to the PC muscle than perianal surface electrodes (B)

Learning by trial and error, makes the EMG biofeedback allows the patient to isolate only the pelvic muscle. Using an instrument of two channels as MyoDac 2TM, computer system, or two units MyoTracTM, electrodes can be placed midway between the abdominal muscle, the navel and pubic bone to help the patient avoid the contraction of these during the year pelvic muscle. There are several methods for training the muscles of the pelvic floor (figure 3). Maximum contractions are made for 5-10 seconds each time with periods of 10 seconds of rest between them. These exercises are repeated several times, until the contraction begins to show fatigue or when the patient begins to compensate with additional muscles.


The training is accomplished with resistance contractions slightly below the maximum value held for increasingly longer periods, for example, a contraction of 50% of the maximum value held for 30 seconds or more. The rate of recruitment is carried out by repeating several contractions in a shorter time, for example, 10 successive contractions over a period of ten seconds. A progressive contraction can also be made and the patient may be asked to contract and relax gradually. The biofeedback time is approximately 15 minutes, the time spent in each type of training depends on the problem of the patient and his response.

A review of registration data, combined with a biofeedback session with a health professional usually is suggested every 7-10 days. The patient is asked to work daily at home full-time equivalent of two or three sessions of EMG biofeedback and exercises for 5-10 muscle contraction were not monitored further. These should consist of three groups of contraction and relaxation exercises per session to begin the process of generalization. During the subsequent weeks, these exercises should be practiced with a growing number of repetitions and effort.



Biofeedback techniques: A case study


Emilio Takase

Federal University of Santa Catarina - SC

Recent studies in neuroscience are showing how cardiac activity can influence the emotional aspect of people (Gödert et al., 2001, Sastre et al., 2000, Kubota et al., 2001). Research on meditation techniques showed also significant changes in the altered state of consciousness through the heart and its relation to brain responses (Peng et al., 1999). These studies can be used to contribute to improving the performance and yield of the athletes. Thus, through a case study, the aim of this study was to develop through the technique of biofeedback model of a cognitive-behavioral intervention in the management of anxiety, fear, stress, among others. The exercise was chosen serve to improve the performance of a mesatenista where the heart rate was monitored. The equipment used to measure heart rate was one meter from the Polar Heart Rate, Vantage model. Initially, the athlete was asked to get used to the machine chest strap and watch the heart rate through inspiration, expiration and stopped breathing for a few seconds. In the first phase, the table tennis was for two weeks training / practicing of the exercises (inspiration, expiration, and respiratory arrest) at the time of withdrawal. In the second phase, during a training of 30 minutes was carried out exercises two sequences, two drawings of a forehand followed 30 seconds. The results suggest that biofeedback exercises, using heart rate as a reference, can act to improve the performance of the drawing table tennis.

Support: Polar in Brazil

Bibliographic reference:

Gödert, H.W., Rill, H.G. & Vossel, G. (2001). Psychophysiological differentiation of deception: the effects of electrodermal lability and mode of responding on skin conductance and heart rate. International Journal of Psychophysiology, 40: 61-75.

Kubota, Y., Sato, W.; Toichi, M., Murai, T., Okada, T., Hayashi, A.; Sengoku, A. (2001). Frontal midline theta rhythm is correlated with cardiac autonomic Activities During the performance of the attention demanding meditation procedure. Cognitive Brain Research, 11: 281-287.

Peng, CK Kneadus, JE, Liu, Y., Khalsa, G., Douglas, PS, Benson, H. & Goldberger, A.L. (1999). During heart rate oscillations exaggerated meditation two techniques. International Journal of Cardiology, 70: 101-107.

Sastre A., Graham, C., Cook, M.R. (2000). Brain frequency magnetic field alter cardiac autonomic control mechanisms. Clinical Neurophysiology, 111:1942-1948.


The importance of biofeedback in the process of weaning.

in Brief

A 21-year-old male, post-trauma-sequel spinal level C6-C7 since October 1998, victim of the projectile from a firearm. Since then, I am bound to IMV.

The program through biofeedback ventilator weaning was applied in eleven sessions of approximately two hours, starting on 3/13/01 until 4/30/01, consisting of assessments during this period the classical respiratory therapist, with the intention of the certainty of maintenance of the patient without any complication.

Feedback was used both visual and auditory, to return to the patient of their normal respiratory function, as well as the balance of your autonomic nervous system due to the decrease of stress, anxiety arising from the process developed by the patient during the weaning of the prosthesis ventilation.


Katia Marques - Physiotherapist

Marcia Cashew - Physiotherapist

Regina Celia Gomes - Physiotherapist

Marcelo Vasconcellos Mendes

16 de Maio de 2012

Holding a ball of 300g is not easy!

Newton Ball is a device that has a system of gyroscopic high speed, which generates motion and strength of up to 16 kg. It is one of the most compact mechanical exercise devices that exist: a sphere about the size of a tennis ball. Remarkably accurate, Newton is produced with resources and high quality materials. The Newton is the most modern and effective exercising muscles and joints of the fingers, hands, wrists, arms and shoulders. Tones and defines muscle mass by training only a few minutes a day.

Newton Ball Classic

16 de Abril de 2012

Learn more about biofeedback treatment.

The biofeedback treatment is simply the immediate return of sensory information through electronic devices on physiological processes (heart rate, peripheral temperature, galvanic skin response, muscle tension, blood pressure and brain activity). The method allows a person to voluntarily regulate their emotional and physiological reactions. The use of sensitive electronic equipment amplifies and transforms the physiological responses to light and sound signals that are used to prevent diseases. All physiological processes can be controlled through the use of biofeedback. The training includes different methods of awareness and relaxation techniques such as muscle, respiratory, and cognitive autogenic. The term "biofeedback training" came into use around 1969, when proved to be a useful tool in teaching and learning processes that involve self-regulation training. In a narrow sense can be conceptualized by a vision etymological feedback. Radical feed, food, and the radical back, back, you get the feedback of a system. In the parlance, the term feedback can also be regarded as providing information about the state of a system. For example, pending the loading of a particular site, a loading bar shows the user the percentage already completed. In these clinical settings and other procedures for self-regulation acquired by biofeedback training can be used to reduce or eliminate symptoms of organic or disorders related to stress, to restore muscle function and reducing pain resulting from an injury or disease. May be the primary therapeutic modality or in combination with other therapeutic interventions such as lifestyle counseling, training in desensitization, cognitive restructuring or psychotherapy. Gradually biofeedback training has developed into a powerful therapeutic procedure. In educational and business, biofeedback training is a tool for the development of deep relaxation and stress management, processes that are important in preventing stress-related illnesses. In all applications the goal of biofeedback training is self-regulation - learning how to control both the physical and mental functioning for a better and healthier.

15 de Abril de 2012

Sleep disturbances
Nocturnal apnea is a sleep disorder?

Apnea is the suspension of breathing during sleep. These episodes of apnea (Greek ápnoia, shortness of breath) may last a few seconds, after which they resumed normal breathing and occur several times during sleep. In most cases are not sufficient to awaken the person, but there is a change in sleep pattern, going from deep sleep to a more superficial sleep. As this sleep is not restful, typical manifestations are a feeling of "last night's" awakening, as well as fatigue and drowsiness during the day.


... is the loss of physical and mental balance of a person as a result of internal stressors (personality traits) and external (competitiveness, traffic, violence, finally, the pace of life).

Stress has three phases:
-Activation of Office - corresponds to the creativity, motivation, implementation capacity;

-Search of Balance (or stress resistance) - the body does not find the balance point, it passes to the next stage;

Corrosion-stage - where it appears the negative side: psychosomatic diseases, diabetes, ulcers, gastritis, memory loss, difficulty concentrating, low productivity, fatigue, exhaustion, high blood pressure, low immunity (increasing the incidence of infections and diseases) , skin problems, allergies, decreased libido and obesity. Under psychological stress affects the apathy, difficulty concentrating, loss of immediate memory, emotional indifference, low productivity, insecure, depressed mood, panic disorder and creative functions impaired.