Summary: Operant Conditioning or Computer
Aided Biofeedback is a novel technique perfected by Dr. Brucker and his team at
Miami University, USA, that uses biofeedback to teach dormant redundant areas of
brain to take over the muscular control of areas in brain that are irreversibly
This technique has shown promise in Cerebral palsy too, and is now the subject of study at UDAAN as a part of the Multimode Therapy program.
Last updated November 14, 2005
Operant Conditioning / Biofeedback Therapy for Cerebral Palsy
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Operant Conditioning or Computer aided Biofeedback is a method of training unused brain cells to take over the function of damaged brain cells. It believes that brain is not a static compartmentalized organ but rather a plastic one that can modify itself to deal with changing circumstances. One of the pioneers of this method Dr. Brucker and his team at Miami University of USA. It is partially effective in restoring useful muscle function even years after a paralytic episode.
Brain learns from sensory inputs during training. No one knows anything when born. It is by trial and error, falling and getting up again but always learning from various sensory inputs that the brain develops a specific program that enables one to ride a bike or play a piano skillfully.
Even in a paralyzed muscle, a few muscle fibers remain active, but they are too few in number to cause noticeable movement. In the absence of any recognizable sensory biofeedback when the patient tries to move the limb, the brain does not know when it fired the correct neurons to cause the minor unfelt movement, and therefore does not learn to use the few surviving neurons more usefully and predictably.
During Operant Conditioning, highly sensitive electrodes are placed on the limb to be trained. The patient is repeatedly asked to try to move the limb. Whenever the correct neurons are fired, the electrodes pick up the signal and show it as a spike on the computer screen, sometimes accompanied by a sound as well. This “sensory feedback” encourages the brain to learn how to use those surviving neurons at will to predictably fire the muscle fibers on demand. This biofeedback gradually encourages surrounding redundant neurons (we have a trillion of them) to modify themselves to join forces with the surviving neurons to produce recognizable movement at that joint.
It usually needs 10 to 20 sessions spread over as many days to train one joint to develop useful recognizable activity.
Thereafter, the OT/PT therapists take over for the next 4 to 6 months to develop the movement fully into useful activity at that joint. After that, the patient needs further Biofeedback to train the next joint.
Training major joints is easier than peripheral small joints of fingers/foot.
We believe that after the 4th month of the Multimode Therapy regimen, when the receptivity of the brain is maximum, will also prove to be the optimum time to try Biofeedback as the fifth element of experimental therapies in Multimode Therapy.
Unfortunately, it is not available at Delhi, but Apollo hospital at Chennai may be doing it.
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