1495-E.PH./Reviews EUR MED PHYS 2003;39:00-00 Current applications of biofeedback to physical medicine and rehabilitation D. MOSS 1 , G. E. SELLA 2 , F. ANDRASIK 3 , S. DONALDSON 4 , P. LEHRER 5 , O. PALSSON 6 , E. PEPER 7 , M. B. STERNAN 8 Clinical biofeedback has a 35 year history of develop- ing applications to disorders in physical medicine and rehabilitation. The authors summarize the para- digm of biofeedback, discuss its mechanisms, and review current protocols for the treatment of asthma, epilepsy, fibromyalgia, headache, myofascial pain disorders, repetitive strain disorders, and urinary incontinence. Biofeedback interventions are compat- ible with and often augment the therapeutic effects of conventional medical, pharmacologic and manual interventions. Biofeedback offers evidence-based alternative therapies for a variety of common disor- ders in rehabilitation. KEY WORDS: Physical medicine - Rehabilitation - Biofeed- back. Clinical biofeedback B iofeedback is an evidence-based, non-phar- macologic treatment developed over the past 35 years, with documented applications to many common disorders in physical medicine. 1-3 The bio- feedback treatment paradigm is simple. The bio- feedback therapist places a sensor or several sen- sors on the surface of the body, measuring specific physiologic processes. The biological signal is pro- cessed electronically, and an auditory or visual sig- nal is displayed to the patient. With feedback, the patient develops more awareness of the physiologi- cal process, and gains partial or complete control over the process. 1 Saybrook Graduate School, San Francisco, CA, USA 2 West Virginia University School of Medicine Morgantown, WV, USA 3 University of West Florida Pensacola, FL, USA 4 Myosymmetries Calgari, Alberta, Canada 5 UMDNJ, Robert Wood Johnson Medical School Piscataway, NJ, USA 6 University of North Carolina Chapel Hill, NC, USA 7 San Francisco State University San Francisco, CA, USA 8 School of Medicine, University of California Los Angeles, CA, USA Biofeedback instrumentation is able to monitor musculature throughout the body, peripheral tem- perature, respiration, cardio-vascular rhythms, blood pulse volume, electrodermal activity, cortical rhythms, and other physiological processes. Bio- feedback instrumentation can be used for general relaxation, or more strategically, to modify specific physiological mechanisms contributing to a disor- der. The use of surface electromyography Surface electromyography (SEMG) is critical to many applications of biofeedback within physical medicine and rehabilitation. Recently, a large data- Address reprint requests to: D. Moss, PhD, Psyserv, 1703 S. Despelder, Grand Haven, MI 49417, USA. E-mail: dmoss@chartermi.- net Vol. 39 - No. EUROPA MEDICOPHYSICA 1