PubMed · 2689370
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1989. Biofeedback and diagnostic techniques.. https://pubmed.ncbi.nlm.nih.gov/2689370/
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Efferent motor signals to skeletal muscles concern not only the space/ time pattern of motion, but also the setting of muscular performance and through this the control of the current metabolic rate. For an optimal adjustment of metabolic rate during heavy exercise-e.g. in athletic competitions-a feedback control system must exist, including a programmer that takes into consideration a finishing point (teleoanticipation). The presented experiments, using Borg's scale, indicate the existence and functioning of a system for optimal adjustment of performance during heavy exercise and the relevance of teleoanticipatory effects. Thus motor learning includes not only somatosensory control, but also metabolic control. With regard to migratory birds, such metabolic control would have to operate in the individual as well as in the migrating flock as a whole.
PURPOSE: We report the results of biofeedback (BF) on patients with outlet obstruction defecation (OOC), including those with and without measurable paradoxical puborectalis contractions (PP). Clinical and anorectal physiologic parameters (ARP) were assessed one week before and after a standardized course of BF. METHODS: Sixty-two consecutive patients (24 men, 38 women; mean age, 48 (standard error of the mean, 2.3) years) were recruited. All had persistent constipation despite six weeks of dietary fiber supplements. Colonic inertia was excluded by transit marker studies. Defecating proctography excluded anatomic abnormalities causing outlet obstruction. Patients underwent four outpatient sessions of biofeedback, each session lasting one hour. RESULTS: After BF, 56 patients (90.3 percent) were subjectively improved. Frequency of spontaneous bowel movements were significantly increased (P = 0.003). Frequency of laxative-induced (P = 0.004) and enema-induced (P = 0.005) stools were reduced. Anal resting (P = 0.04) and squeeze (P = 0.002) pressures were increased. Number of patients with PP was reduced from 40 to 31 (P = 0.004). Presence of PP did not affect response to BF. There were no differences in ARP between the 56 patients who improved and the 6 who did not. There were no side effects or clinical regressions after a mean follow-up of 14.9 (standard error of the means, 0.9) months. CONCLUSIONS: BF effectively treated OOC in 90.3 percent, regardless of PP. Anal pressures were increased, and PP was decreased.
Many uncontrolled studies suggest that biofeedback training is an effective adjunctive therapy in improving the outcome of functional constipation and/or encopresis in children. This could not be confirmed in controlled studies. Adding biofeedback training after conventional treatment had failed did not provide benefits. The results of biofeedback treatment in children with functional constipation and/or encopresis are disappointing.