For the Biofeedback Certification International Alliance (BCIA), assessment is the culmination of a learning process that begins with didactic training that is guided by Blueprints of Knowledge and Core Reading Lists. The references in the BCIA Core Reading Lists help applicants master the learning objectives of the Blueprint and are the source of the exam questions. BCIA certification exams test entry-level knowledge that is relevant to the current practice of biofeedback. Applicants can now take exams in both paper/pencil and online formats. BCIA encourages applicants to use the Blueprints as roadmaps to guide their study, to read the Core references, and to take advantage of their mentors' experience. The quality of the applicants, the excellence of didactic programs, and the careful construction of the exams have resulted in pass rates that exceed 70%. BCIA believes that the applicant's journey, not passing the certification exam, is the best metric for measuring success. BCIA has achieved its mission in the time before the professionals arrive at their testing site.

Surface electromyography holds great potential in helping patients recover from injuries that result in motor impairments. To be able to assist the patient, the clinician must consider research obtained from the study of implicit/explicit learning, contextual interference, and basic learning theory. Quantitative surface electromyography (QSEMG) is a technique that is constructed around this basic research in order to present the optimal learning environment for the patient.

The treatment of muscle dysfunction in the muscles around the face is particularly challenging. In addition to being the most observable muscles in the body, the limited area with which to work, the high firing rate, and the increased risk of picking up crosstalk from muscles in close proximity all add to the challenge. This case report describes the treatment of a young child with seventh cranial nerve palsy of the face.

It is regular practice for a clinical investigator to report the findings of any pertinent test. SEMG endeavors to investigate several aspects of skeletal muscular dysfunction. Dynamic SEMG evaluation reporting of the cervical musculature range of motion is the subject of this report. The report content and format is in line with the Daubert Rule of Evidence (Federal Rule 702). The format of the report allows the clinician to present the data in a manner that allows readily for court testimony or other presentation of objective evidence.

The treatment of headache is challenging, and is made more so by the fragmentation of medicine into clinical specialties. Physiologically, migraine headache is a systemic event, affecting multiple neurophysiological systems. Treatment often calls for a multidisciplinary approach. Research supports the efficacy of both general biofeedback and, to a lesser extent, neurofeedback in the treatment of headache, including migraine. Abnormal electrophysiological patterns, detectable with quantitative EEG, are frequently found in patients with migraine, especially after closed head injury. Research has also shown the frequent presence of trigger point activity in several areas of the musculature of the head and neck in headache patients, including those with migraine. Finally, the role of stress has been reported in the onset and exacerbation of headache pain. The authors provide a case study showing the application of quantitative EEG, surface electromyography (SEMG), and psychophysiological stress profiling in the assessment of a 56-year-old female with closed head injury and migraine headache. The treatment included myofascial massage with trigger point release, SEMG training to balance asymmetric muscle tension patterns, and a stress management program, including guided visualization and breath training. This comprehensive intervention produced a significant reduction in headache symptoms and an improvement in work productivity.

The authors cite a Medline review article of biofeedback for urinary incontinence to demonstrate the pervasive lack of standardized operationally defined variables, which precludes the application of evidence-based-medicine standards to the field. As an example of an early-stage evidence-based-medicine model, the Glazer Protocol demonstrates how empirically derived and operationally defined SEMG characteristics hold great promise for a better understanding of the pathophysiology of urinary incontinence and can assist in both diagnosis and treatment of this disorder.

This paper presents two cases of the clinical application of a valid and reliable method of pelvic floor muscle evaluation (Glazer Protocol) using a computerized surface electromyography (SEMG) device. The authors present a male patient with urinary incontinence post–radical retropubic prostatectomy (RRP) and a female patient with hypoactive sexual desire disorder (HSDD) and primary dyspareunia. Radical retropubic prostatectomy is a surgical removal of the prostate through the abdomen. Dyspareunia refers to painful sexual intercourse. Intrapelvic SEMG evaluations were conducted before and after pelvic floor muscle training (PFMT) with biofeedback. Intrapelvic sensors were used with a fixed sequence of voluntary pelvic floor activities and continuous real-time recorded SEMG measures to determine electrophysiological abnormalities and their potential role in the symptomatic presentation. This analysis lead to the development of an individualized pelvic floor muscle SEMG biofeedback program for each patient, aimed at symptomatic relief and functional restoration.