Sorehand- Biofeedback

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Date:    Mon, 11 Dec 2000 08:24:25 -0800
Subject: "Inapropriate muscle tension" and biofeedback

This is another book noted in The RSI Network newsletter for December (see
http://www.ctdrn.org/rsinet/archive/rsinet44-dec00.html), in which the authors
claim repetitive strain injury "is merely one of the factors that contribute to
what they call 'computer-related disorders.' " More food for thought.
Cheers!
Joan

HEALTHY COMPUTING WITH MUSCLE BIOFEEDBACK:
A Practical Manual for Preventing Repetitive Motion Injury
by Erik Peper and Katherine Hughes Gibney

This book debunks what the authors call the "myth" of repetitive strain
injury with insight gained from research, observation, and working with
clients and corporations. The authors note that muscle groups are used
repetitively all the time without injury, and think this is merely one of
the factors that contribute to what they call "computer-related disorders."

Peper, a behavioral psychologist and internationally renowned biofeedback
specialist who directs the Institute for Holistic Healing Studies at San
Francisco State University, believes "Ergonomics doesn't provide all the
answers. You can be working in the 'optimum ergonomic position' and still
be tense." He attributes computer-related disorders to inappropriate muscle
tension. Studies by Peper and his colleagues show that people working at a
computer often raise their shoulders and breathe more shallowly and
quickly, resulting in one or more of a host of symptoms that could lead to
disabling conditions: arm and shoulder numbness, pain and/or tingling in
the wrist or arm, neck and back pain, or eye strain. Their solution is for
individuals to retrain their work habits.

The program described in the book uses a portable surface electromyograph
(sEMG) to help identify work patterns that contribute to unhealthy
behavior. The sEMG provides auditory feedback from electrodes placed on the
skin. The electrodes monitor a muscle's bioelectrical activity when it
contracts and produce signals that emit a range of pitches. The tenser the
muscle, the higher the bioelectrical activity and the higher the pitch that
the monitor emits. This signals inappropriate muscle tension, and the need
to relax the muscles being monitored. The sEMG returns to its normal level
when a muscle relaxes, helping the computer user identify what is required
to maintain relaxed muscles.

Co-author Hughes Gibney believes these sEMG monitors have several
advantages: they help employees retrain their computing habits; help
companies determine which employees are most at risk and thus a priority
for the program; and help those who have gone through the training maintain
healthy habits.

The book methodically outlines training modules, providing a clear and
systematic approach to understanding and preventing computer-related
disorders. The beginning sections focus on assessment and measurement of
upper-extremity musculoskeletal stress, and include practical techniques
and instructions for using portable sEMG monitors at various worksites. The
next section describes techniques for monitoring responses to a set of
standardized biofeedback exercises. The standardized protocols Peper and
Hughes Gibney developed are designed to increase muscle awareness during
computer use, and represent a significant advance for assessment,
treatment, and training. Until now, the lack of standardization made the
task of eliminating CTDs quite difficult.

The authors suggest several approaches for replacing old computing habits
with healthy ones and for taking the guesswork out of ergonomic
evaluations. The text flows logically and reads easily, with clear
illustrations on electrode placement. This book will find a natural
audience among ergonomists, physical and occupational therapists,
psychologists, physicians and osteopaths, chiropractors, body workers, and
other health practitioners who work with somatic disorders.

Healthy Computing with Muscle Biofeedback: A Practical Manual for
Preventing Repetitive Motion Injury, is published by the Biofeedback
Foundation of Europe, and is available from Work Solutions USA, 2236 Derby
Street, Berkeley, CA 94705; e-mail worksolusa@aol.com; fax (510) 658-9801.
The cost is US$29.95 plus shipping and handling (US$5 for the U.S. and
Canada; US$20 international); California residents add applicable sales
tax. For quantities of six or more, contact Work Solutions USA for price
information.

-------------------------------------------

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------------------------------

Date:    Fri, 26 Jan 2001 06:08:29 -0800
Subject: Re: Biofeedback

Yes, I have. After lots of massage/exercise/ice etc. for recurrant
tendonitis, changes in keyboard and mouse, use of Dragon Voice, I was sent
to bio feedback group in California (bay area, cupertino).

Main idea is to learn to dynamically relax muscle tension in hands, arms,
shoulders, back and neck. Also to learn to adjust posture while at PC or
driving, etc. The variety I used was called "operant conditioning" - bio
feedback device attached to various muscles, and then I would do things like
walk, type, sit, play my clarinet, stand, hold a ball, etc., all the time
watching a screen showing muscle activity in various groups, trying to
"feel" how it was when appropriate small relaxing cycles set in.

Did about 1 hr week for 6 weeks, then periodic refresher.... I am due again
soon... quite effective, I feel.

-----Original Message-----
From: Tony
To: SOREHAND@ITSSRV1.UCSF.EDU
Subject: Biofeedback


Hi folks,

I've had two people mention doing biofeedback for RSI. Has anyone on
sorehand done so and had any success? Can you describe the process and how
it helped. Is there a specific type to ask for?

Thanks,
Tony
------------------------------

Date:    Fri, 26 Jan 2001 12:28:18 -0800
Subject: Biofeedback, butterfly board alternatives, and the bookgem

Hi all,
I don't have much time to contribute to this list but do enjoy reading
everyone's posts. Now I can't resist as I do have some experience to offer
up here.
My husband and I both have RSI and have used biofeedback and the butterfly
board. Here is our experience...
We each went to Nova Care in Oakland where they hooked us up to biofeedback
computers in order to determine our prescription for ergonomic devices and
adjustments to our workstations. It was invaluable and educational about the
whole process of ergo eval.

While hooked up to the computer, they put each of us on a series of setups
(different mice, keyboards, chairs, and forearm rests). The results were
amazing. As I typed, I could see the graph of biofeedback data and the
therapist instructed me to try to modify my typing and relax my upper body
to keep the reading from rising above a certain level. By doing this withe
each alternate device in turn, we came up with the best equipment and
adjustments for me.

The best results for me occurred with a negative tilt keyboard tray, kinesis
classic keyboard and a trackball used with the left hand, as well as a
forearm rest called the "moerency double forearm rest," and of all things, a
towel rolled up and placed over the top of the chair down the middle of my
back.

For my husband, he got results with a very different set of gear. He needs
to be leaning back with a positive tilt, kinesis classic keyboard, the 3M
Renaissance mouse (formerly anir DR. mouse which looks like a joystick) with
his right hand, and the butterfly board that has been discussed here
recently.

the thing I wanted to point out and recommend is that we both have very
similar symptoms and are both right-handed, but the biofeedback and help of
proffesional evaluators, we each have very different prescriptions that i
believe have helped us heal and work without re-injury. I would have never
figured this out without biofeedback and probably would have wasted tons of
money on ergo stuff that wasn't right for me. I can barely stand to work at
his station and vice versa.

We aren't using our kinesis keyboards yet, partly because we are waiting for
work comp to pay for biofeedback keyboard retraining, where we will be once
again hooked up to the machines and see the results as we re-teach ourselves
how to type. The kinesis is too hard for us to use without retraining--thus
far been sort of frustrating.

but please do check out the morency arm rest before you buy the butterfly
board...when i first set it up and sat at my station, the relief was
instantaneous. if you cant get biofeedback, try to go to a showroom where
you can try both butterfly and morency to see which one works for you, or
alternately order from someone with a good return policy. I got my morency
rest for around $100 at the following url:
http://www.alimed.com/SiteObjects/shop_cart.cfm?SHOP=0&e=312&buyer=1&search=
1   and if that doesn't work try a search at www.alimed.com which was not
easy i will warn you (seems they need some web dev help).

Also, wanted to share that we bought the "book gem" www.bookgem.com, and
wanted to thank whoever recommended it...its fabulous and by far the best
device of its kind we have found. super light weight, flexible, functional
and it really works well.

Hope that helps someone out there.

Blessed Be,

Stacey
------------------------------
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Date:    Wed, 31 Jan 2001 22:37:13 -0800
From:    Joan 
Subject: Biofeedback instrumentation

I don't know about home-made devices, but a company called Thought
Technology Ltd. In North West Chazy, NY manufactures a palm-sized EMG
monitor called a MyoTrac and other "versatile systems for rehabilitation
and monitoring." Their 800 number is 1-800-361-3651 (9-5 EST), and their
website is http://www.thoughttechnology.com. Dr. Erik Peper -- a
behavioral psychologist and director of San Francisco State University's
Institute for Holistic Healing Studies -- uses them, and reported on
biofeedback in the last issue of The RSI Network; I posted the article to
Sorehand on 12/11. Unfortunately the review in the "Current Issue" of the
newsletter on the Web is incomplete (see
http://http://www.tdrn.org/rsinet/archive%/rsinet44/dec00.html; it's the 2nd
review: HEALTHY COMPUTING WITH MUSCLE BIOFEEDBACK: A Practical Manual for
Preventing Repetitive Motion Injury), but if you go into the 2000-2001
archive and find the December issue in RTF the complete review appears.

I've had biofeedback sessions in a clinic, which I found to be helpful, but
I think working with this portable device every day for a while would be a
lot more useful . . .

Joan
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