Biofeedback training: A critical review of its clinical applications and some possible future directions

The clinical effectiveness of biofeedback training is discussed in first section. EMG feedback of the frontalis muscle in tension headache and EMG feedback for neuromuscular reeducation gave positive results which were replicated in different laboratories. The application of theta suppression biofeedback to vigilance tasks and SMR biofeedback (sensorimotor rhythm) for the treatment of epileptics are difficult to evaluate because of methodological shortcomings. In cardiovascular disorders, cardiac arrhytmias were successfully treated by HR-biofeedback. However, the biofeedback of high blood pressure does not seem to be more effective than classic relaxation methods. The same is true for biofeedback in stress related disorders ('Anxiety'): it is not clear whether biofeedback produces positive effects in addition to relaxation methods. In a second section pattern biofeedback is proposed as an alternative approach to the treatment of anxiety disorders and a first experimental step in the direction of an application of pattern feedback is described. The necessity of integrating biofeedback into a broader behavior therapy concept is stressed.