Biofeedback

The Different Types of Biofeedback Explained

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Each type of biofeedback is named after the body signal it measures: muscle tension, skin temperature, sweat gland activity, heart rhythm, breathing or brainwaves. The sensor and the screen differ, but the principle is the same: see the signal, change it, learn what changes it. The type matters because research results apply to a specific type and a specific condition, not to biofeedback in general.

Muscle tension (EMG)

An electromyograph uses surface electrodes on the skin over a muscle to pick up the electrical activity that makes it contract, measured in millionths of a volt, according to the Wikipedia article on biofeedback. On screen, you see a line or a bar that rises as the muscle tightens and falls as it lets go, so you can follow tension in places such as the forehead, jaw or shoulders.

Skin temperature

A small temperature sensor attached to a finger or a toe shows changes in skin temperature. The same article explains that skin temperature mainly reflects the diameter of the small arteries near the surface, so the reading reflects how open those vessels are. The aim is to learn to shift that number in the direction your practitioner sets.

Sweat gland activity (electrodermal)

An electrodermograph passes a current too small to feel across the skin of the fingers or hand and measures how easily it travels. Sweat gland activity changes that reading, and the article notes that these measurements have a long history in lie detection. According to the article, unexpected stimuli, arousal, worry and mental effort can all increase sweat gland activity, which is what the sensor picks up.

Heart rate and heart rate variability

Two kinds of sensor are used here. An electrocardiogram uses electrodes on the torso, wrists or legs to record the heart’s electrical activity, and a photoplethysmograph can measure pulse, heart rate and heart rate variability, which is the beat-to-beat change in the interval between heartbeats.

Breathing

A flexible band placed around the chest, abdomen or both measures how they expand and contract, and counts breaths per minute. You can see whether you breathe mostly with your chest or your belly, and how fast.

Brainwaves (EEG, or neurofeedback)

An electroencephalograph uses electrodes on the scalp to measure the electrical activity of the brain. This form of training is also called neurofeedback.

Why does the type matter?

Because the evidence is specific. A 2019 evidence map of systematic reviews found that in fibromyalgia, EMG biofeedback, but not EEG biofeedback, had the potential to improve pain; in the map’s own table, the benefit was for short-term pain intensity, with no difference in the longer term. In that fibromyalgia review, the only one on the map to report harms specifically, findings ranged from no harm to stress with EMG biofeedback, and fatigue, headache and sleep problems with EEG biofeedback.

A result for one type and one condition does not carry over to another. A study of muscle feedback for headaches says nothing about brainwave training for the same problem.

Matching a type to your goal

Start from the problem, not the device. Ask the practitioner which signal they plan to train and why it fits your symptoms, whether there is research on that type for your condition, and what you will be able to practice at home without the equipment.

This article is general information, not medical or psychological advice; talk with a licensed clinician about your own situation.

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