Biofeedback - Whole Health
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  • Biofeedback is a process that uses your body’s own signals like heart rate and body temperature to bring about healthy changes.
  • Neurofeedback (or EEG biofeedback) is a type of biofeedback that specifically uses brain wave signals to bring about healthy changes.
  • Biofeedback can improve health issues that are caused or worsened by stress. Using a two-step process, biofeedback can help you relax and reduce your stress.
  • Neurofeedback can improve health through shifting brain wave patterns in such a way there is a concomitant shift in cognition or mood.
  • Clinical biofeedback involves interaction between a provider, a client, and a machine/device providing feedback from body-derived signals.

Background and Policy on in VA

Biofeedback is one of the evidence-based complementary and integrative health (CIH) approaches covered by the Veterans medical benefits package when deemed clinically necessary by their care team per VHA Directive 1137 – Provision of Complementary and Integrative Health, published in May 2017. Based on literature review these approaches were found to be safe and have sufficient evidence of benefit to be recommended as appropriate components of care for the Veteran population.

Biofeedback Safety and Effectiveness

An evidence map of biofeedback was developed by the VA Health Services Research & Development. Conditions with evidence of positive effect include: migraine and tension-type headaches, secondary outcomes of headaches (medication intake, muscle tension, anxiety, and depression, etc.), Stroke, urinary incontinence (related to prostectotomy, fecal incontinence. Conditions with potential positive benefit: balance/gait training, fibromyalgia, hypotension. Conditions with mixed or unclear benefit: sleep bruxism, chronic idiopathic constipation, knee osteoarthritis, balance/gait training.

Also found was high-confidence evidence that biofeedback as an adjunctive treatment for pelvic floor muscle training (PFMT) can result in both immediate- and long-term improvements in urinary incontinence for men after a prostatectomy as compared with PFMT alone.

Occupational Guidance

All Biofeedback providers must be Licensed Healthcare Practitioners (LHPs). Examples include but not limited to: psychology, nursing, physical therapy, social work, counseling. Additionally, they must be trained in the specific modality they offer. This basic training is generally:

  • 36 hours for general biofeedback
  • 36 hours for neurofeedback (EEG Biofeedback)
  • 10 hours for Heart Rate Variability training (training must be specific to HRV)

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