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FROM THE EDITOR

Advances in the Use of Neurofeedback with Traumatic Brain Injury

PhD

The cover of this Fall issue of Biofeedback shows a view of the beautiful Town and Country Resort Hotel in San Diego, the scene for Association for Applied Psychophysiology & Biofeedback's 2010 Annual Meeting. Mark your calendars now for the Workshops (March 24–25, 2010) and the Annual Meeting (March 25–27, 2010).

Each year in the United States, approximately 1.5 million people sustain a traumatic brain injury (TBI). About 5.3 million Americans live with a disability related to TBI, and each year 80,000 additional persons become disabled with TBI (Centers for Disease Control and Prevention, 1999). Today's

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PROFESSIONAL ISSUES

What Has Biofeedback Certification Institute of America Been up to?

PhD, BCIAC and

DOI: 10.5298/1081-5937-37.3.85

Abstract

The Biofeedback Certification Institute of America (BCIA) board has actively involved our certificants in strategic planning designed to strengthen our advocacy for the issues that concern them, improve an already successful certification process, and identify initiatives that will add value and recognition to our credentials. This article details the exciting actions that we have taken to protect the welfare of biofeedback consumers, to provide credibility to biofeedback practitioners, and to advance the field of biofeedback.

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Ethical Treatment of Traumatic Brain Injury

PhD

DOI: 10.5298/1081-5937-37.3.88

Abstract

Traumatic brain injury is a frequently occurring event. Often it is not diagnosed in a timely manner. Neurofeedback interventions have not yet been recognized as a treatment of choice. This lack of acceptance of neurofeedback as a treatment of choice may well be due to a scarcity of published control group studies. In addition, the use of the quantitative electroencephalography, one of the most promising diagnostic and treatment planning tools, has been opposed by the American Academy of Neurology (AAN). Yet sufficient clinical and published research data exist to warrant the use of the quantitative electroencephalography as a supplemental tool for diagnostic and treatment planning purposes and the use of various neurofeedback interventions for overcoming many of the symptoms of traumatic brain injury. Practitioners must remain current on both clinical and research data if they are to practice both ethically and competently. In addition, they must attend to other ethical issues such as informed consent, competence, and practice guidelines and standards.

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SPECIAL ISSUE

The Elusive Nature of Mild Traumatic Brain Injury

PhD

DOI: 10.5298/1081-5937-37.3.92

Abstract

The author discloses a personal history of undiagnosed mild traumatic brain injury (MBTI) and identifies a typical course and progression of this condition. He advocates a careful inquiry for possible head injury whenever the clinical history shows an original period of normal functioning, a progression of disturbance over time, multiple diagnoses, and poor response to treatment with medication. He discusses the use of quantitative electroencephalography (QEEG) in assessing possible mild traumatic brain injury, describes typical features of quantitative electroencephalography in mild traumatic brain injury, and cautions about the frequency of false negatives. He provides two case histories showing the progression of disturbing cognitive, personality, and impulse control problems following early head injuries.

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The Rehabilitation of a Traumatic Brain Injury With the Coordinated Allocation of Resource Model

PhD

DOI: 10.5298/1081-5937-37.3.96

Abstract

A case analysis of a person with a traumatic brain injury (TBI) is presented in detail. The analysis employs the coordination allocation of resource (CAR) model of brain functioning and the activation quantitative EEG analysis of brain response patterns. This model states that individual cognitive tasks involve specific frequencies and locations for successful performance and employs a flashlight metaphor for conceptualization of spectral correlation coefficient relationships between locations. The employment of this model in this specific case resulted in dramatic improvements in auditory memory (+5.4 standard deviations) as well as other improvements in cognitive functioning, albeit not all cognitive functioning skills.

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Low Energy Neurofeedback System Treatment of an Acquired Brain Injury due to Sudden Cardiac Arrest

PhD

DOI: 10.5298/1081-5937-37.3.100

Abstract

There is confusion regarding whether to identify brain injuries as a traumatic brain injury, an acquired brain injury, or a combination of both. No matter what you call it, brain injuries are a major public health problem. This article demonstrates the power of the Low Energy Neurofeedback System, a form of electroencephalography biofeedback/neurofeedback, with a 71-year-old woman who had a sudden cardiac arrest and was without pulse or respiration for 8 to 10 minutes. NeuroField and hyperbaric oxygen therapy were added later on in the treatment process.

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The Special Applicability of the Low Energy Neurofeedback System Form of Neurofeedback to Traumatic Brain Injury: I. The Theory

PhD, BCIA-EEG

DOI: 10.5298/1081-5937-37.3.104

Abstract

Each year, 1.5 million Americans suffer head injuries, and many of these injuries go untreated, while mainstream medicine uses powerful diagnostic tools and weak therapeutic ones. Neither psychopharmacology, behavioral, nor psychotherapeutic therapies hold much promise, and the symptoms of traumatic brain injury (TBI) are often misunderstood and misdiagnosed. Neurofeedback, with its EEG-based diagnostic approach and its therapies aimed at redirecting neural processing, seems ideally suited for therapy with TBI, but of the traditional neurofeedback paradigms (some going high and some low in their desired training frequencies), there is no one size that fits all. However, the flexibility bestowed by the Low Energy Neurofeedback System (LENS) form of neurofeedback breaks through entrenched maladaptive patterns and opens new possibilities for sufferers of TBI. The success of the LENS approach shows the efficiency of a specific cutting-edge technique and the efficacy of neurofeedback in general as a therapeutic modality.

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Serendipity and the Subdural Hematoma

QEEG-Diplomate

DOI: 10.5298/1081-5937-37.3.108

Abstract

Mild traumatic brain injury is often missed in the course of treating other injuries. This failure to identify the brain injury can be critically important, even life threatening. This report shows one such case in which the brain injury was overlooked, possibly because of the differential effect of age on the severity of the damage incurred from what appeared to be a mild trauma. Distant to the time of the injury, deficits in speech fluency and word finding led the individual to seek further evaluation, and imaging studies revealed a large subdural hematoma. CT scan images are included.

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FEATURE ARTICLE

Limb Position Biofeedback for Patellofemoral Pain

PhD, PT, CSCS

DOI: 10.5298/1081-5937-37.3.112

Abstract

Individuals with excessive internal hip rotation and knee valgus during functional movement often develop abnormal lateral patellar tracking, sometimes resulting in anterior knee pain. A configuration of currently available biofeedback instruments, including an electronic goniometer, can provide feedback on limb position, which is useful in correcting the knee valgus. The article reports on the use of this biofeedback system with three individuals with measurable knee valgus, producing a remediation of the limb angle in each case.

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Keep Cell Phones and PDAs Away From EMG Sensors and the Human Body to Prevent Electromagnetic Interference Artifacts and Cancer

and

PhD

DOI: 10.5298/1081-5937-37.3.114

Abstract

Cell phones produce electromagnetic interference (EMI), which can cause artifacts in physiological recordings and be misinterpreted by the clinician. This study investigated the possible effect of EMI (electrical artifact) on physiological recordings when cell phones are activated/ringing. The procedure consisted of placing the cell phone at varying distances from surface electromyographic sensors. Depending on the orientation of the cell phone's antenna, the EMI produced an artifact in the physiological signal for up to 175 cm (6 ft) that can be misinterpreted by the therapist. To avoid EMI artifacts, clients and therapists should turn off their cell phones when recording physiological signals. This means turning the cell phone off and not just switching it to vibrate. In addition, recent epidemiological studies suggest that long-term intensive cell phone use may increase the risk of gliomas, auditory tumors, and salivary tumors on the side of the head to which the person places the cell phone. Thus, to reduce artifacts and biological harm, the authors recommend keeping the cell phone away from the body and the biofeedback equipment.

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