Transcript Next Polygram 98 Update

Biofeedback
FUNCTIONAL
DIAGNOSTICS
FUNCTIONAL
DIAGNOSTICS
Copyright MFD 2001 - Any kind of reproduction is prohibited
GASTROINTESTINAL
Biofeedback
 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 Auditory
and/or Visual information about Physiological
Process
 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 Pelvic
Floor Dysfunction by teaching patients to
change physiologic responses
FUNCTIONAL DIAGNOSTICS
GASTROINTESTINAL
Biofeedback
Descending

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
.
Anal kanal
S2
S3
S4

By watching the monitor the
patient gets the Feedback
 information and he can adjust his
thinking and behavior

Motor
.
The Goal is to Improve Pelvic Floor
Function by teaching patients to
change physiologic responses
FUNCTIONAL DIAGNOSTICS
GASTROINTESTINAL
The biofeedback process
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Perform first biofeedback training in clinic
Help patient train at home
Perform biofeedback assessment in clinic to
evaluate progress
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Change difficulty level
More home training
Biofeedback assessment to evaluate
progress
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Change difficulty level
FUNCTIONAL DIAGNOSTICS
GASTROINTESTINAL
The Patient Selection Process
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Evaluate patient - diagnostic tests: AFT/others
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Diagnose patient
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Incontinence
Constipation
Others
Evaluate whether this patient
would benefit from Biofeedback (patient
must be capable to cooperate)
FUNCTIONAL DIAGNOSTICS
GASTROINTESTINAL
Pathologies
Non-Neurogenic Origin
Incontinence
 Stress Fecal Incontinence
 Weak external Sphincter
 Dyssynergia IS/ES to Rectum
 Pelvic Floor Muscles Dysfunction
 Constipation
 Due to Anismus
FUNCTIONAL DIAGNOSTICS
GASTROINTESTINAL
With Polygraf ID®
Polygraf ID
 Various background screens are available
 Curves analysis to quantify training and improvement
FUNCTIONAL DIAGNOSTICS
GASTROINTESTINAL
Biofeedback
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Marketing package;
Product flyer
Summaries of reference
articles
Sample reports
Example Data Export
files
Training program
FUNCTIONAL DIAGNOSTICS
GASTROINTESTINAL
Biofeedback Protocol Settings
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Primary (and secondary) channel
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Capture display rate
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5
4
Track (Squeeze, Relax)
1) Initial wait
2) Response time
3) Duration
4) Target level
5) Tolerance
6) Number of repetitions
1
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Graphics for lane, above lane, below
lane and sprite (BMP files)
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Sound (wave file)
2
3
FUNCTIONAL DIAGNOSTICS
GASTROINTESTINAL
Running Biofeedback
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Run non-saving mode
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Run saving mode
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1 or more recordings (training paradigms)
Review
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Important: Change of protocol must be done
before you enter saving mode
Lane displayed
“Hidden” markers - bar
Calculations (mouse over)
Report
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Protocol used
Fulfillment in percent (percentage time within lane)
Relax, squeeze, total
FUNCTIONAL DIAGNOSTICS
GASTROINTESTINAL
Pelvic Floor Training
I try to Contract or relax my
Sphincters and keep my
Abdominal Wall Relaxed !
constipation
SPHINCTER
ABDOMINAL
Sphincter
and
Abdominal Muscle activity
FUNCTIONAL DIAGNOSTICS
GASTROINTESTINAL
EMG measurements in general

What is measured?
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Muscle electrical activity over a bundle of muscle
fibers
FUNCTIONAL DIAGNOSTICS
GASTROINTESTINAL
EMG measurements in general
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How is it measured?
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Absolute:
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Pre-calibrated with a known amplifier and sensor
sensitivity.
Measured in mV
Relative
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Patient relaxation and maximum squeeze is the
calibration points.
Measured in percent
FUNCTIONAL DIAGNOSTICS
GASTROINTESTINAL
EMG measurements in general
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How does the EMG filter in Polygram 98 work?
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Rectifies incoming signals
Signal smoothing:
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High pass filter
0.2 second time constant
FUNCTIONAL DIAGNOSTICS
GASTROINTESTINAL
Reviewing Biofeedback
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Review

Lane displayed

“Hidden” markers - bar

Calculations (mouse over)
 Report
Protocol used
Fulfillment in percent
(percentage time within lane)
Relax, squeeze, total
FUNCTIONAL DIAGNOSTICS
GASTROINTESTINAL
Accessories
EMG Electrodes
Pressure Catheters
Anorectal
1. Disposable Surface
2. Disposable Anal and Vaginal
3. Reusable Anal Sphincter
With Abdominal catheter insertion lumen
1
3
2
FUNCTIONAL DIAGNOSTICS
GASTROINTESTINAL
FUNCTIONAL
DIAGNOSTICS
FUNCTIONAL
DIAGNOSTICS
GASTROINTESTINAL