Software Manual

Version 4.0

Contents 1. Introduction ____________________________________________________________ 5

1.1 1.2 System requirements _______________________________________________________5 Music license______________________________________________________________5

Installation _____________________________________________________________ 6
2.1 2.2 2.3 2.4 2.5 2.6 Software-Installation _______________________________________________________6 Hardware-Installation ______________________________________________________6 Start program_____________________________________________________________6 Searching for the radio modules______________________________________________7 Accelerate program start ___________________________________________________8 Using more than one radio module of the same type _____________________________9

Running a session ______________________________________________________ 10

3.1 3.2 3.3 3.4 3.5 3.6 3.7
3.7.1 3.7.2 3.7.3 3.7.4 3.7.5 3.7.6

Initial settings ____________________________________________________________10 Starting a session _________________________________________________________12 Selecting the measurement channels _________________________________________13 Requesting data __________________________________________________________14 Settings in the data window ________________________________________________15 Scaling of readings ________________________________________________________16 Providing acoustic support _________________________________________________17
Audio feedback ________________________________________________________________ 18 Music from the computer ________________________________________________________ 18 Music from a CD_______________________________________________________________ 18 Voice recorder_________________________________________________________________ 18 Voice recorder playback _________________________________________________________ 18 Volume control ________________________________________________________________ 18

3.8 3.9

Settings using the bottom bar _______________________________________________19 Ending a session __________________________________________________________20

Chart and evaluation ____________________________________________________ 21

4.1
4.1.1

Evaluating heart rate variability ____________________________________________23

Description of the statistical parameters _____________________________________________ 24

Program control ________________________________________________________ 29

5.1
5.1.1 5.1.2 5.1.3 5.1.4 5.1.5

Database ________________________________________________________________29
Open diagram/database __________________________________________________________ 29 Select/new client _______________________________________________________________ 30 Copy data ____________________________________________________________________ 30 Call up statistics module _________________________________________________________ 30 End program __________________________________________________________________ 30

5.2
5.2.1 5.2.2 5.2.3 5.2.4 5.2.5 5.2.6

Settings _________________________________________________________________31
Basic settings__________________________________________________________________ 32 Set chart______________________________________________________________________ 39 Set stress test __________________________________________________________________ 41 Access authorisation ____________________________________________________________ 42 Software module _______________________________________________________________ 42 Therapy library ________________________________________________________________ 43

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5.3 5.4 5.5
5.5.1 5.5.2

Session preselection _______________________________________________________53 Creating a modular screen _________________________________________________54 Using a modular screen ____________________________________________________58
Pre-prepared EEG screens________________________________________________________ 59 Heart rate variability training _____________________________________________________ 60

5.6
5.6.1 5.6.2 5.6.3 5.6.4 5.6.5

Selecting modular objects __________________________________________________62

Line graph ____________________________________________________________________ 63 Data window __________________________________________________________________ 63 Bar-chart _____________________________________________________________________ 64 Video player __________________________________________________________________ 64 Frequency analysis _____________________________________________________________ 65

5.7 5.8

Sensor position ___________________________________________________________66 Help ____________________________________________________________________66

Connecting the VTS and Biofeedback 2000 x-pert ______________________________ 67

6.1 6.2
6.2.1 6.2.2

Preparing and running a session ____________________________________________68 Evaluation_______________________________________________________________68

Session evaluation with time markers _______________________________________________ 68 Session evaluation using triggered potentials _________________________________________ 70

Notes _________________________________________________________________ 71

Updated on:

09.10.2009

Written by: Judith Mader, Dr. Wolfgang Marx, Dr. Stefan Chroust, Ronald Lilleg
Release (Date / Name): 22.10.2009/_______________________

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1. Introduction
This manual contains descriptions of all the available modules. Depending on which modules you have purchased, your software package may not include all the functions. It is assumed that you are familiar with the functions and commands of Windows and with the use of the keyboard and mouse. If necessary you should consult the Windows help files or manuals.

1.1 System requirements

PC or laptop with Pentium or compatible CPU, min. 1.5 GHz at least 1 GB RAM graphics card (suitable for playing videos) 16-bit MIDI-capable sound card with speakers or headphones CD or DVD drive hard disk (with at least 1 GB free space) mouse, keyboard a free USB port for the radio pyramid serial ports for Physio Recorder, marker cable or control of an external device (if used) operating system: Windows 2000, Windows XP or Windows Vista 32, Windows 7

1.2 Music license

Music composed and produced by Detlef Blanke. Available on the CDs Abendstimmung Mentalis 20802 and Wiegenlieder Mentalis 20801, on which they were first published.
Music title Sundown I can see the moon In a saxy mood Winter evening Wiegenlied Schlaflied Length [mm:ss] 5:11 3:11 2:18 3:03 3:17 2:52

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2 Installation
2.1 Software-Installation
Check that the system date is set correctly in your computer. Insert the installation CD supplied with the device into your CD-Rom drive (Windows must already be running). Installation starts automatically1. Use the Next button to move through the installation process.

2.2 Hardware-Installation
After successful software installation the radio pyramid needs to be installed. Plug the provided pyramid into the USB port and install the necessary drivers. Details to this process can be found in the manual of the radio modules (Hardware Manual).

2.3 Start program

After successful installation the program can be started by double clicking the yellow pyramid on your desktop.

If Autostart is not enabled on your computer, you will need to start the installation program manually. On the task bar, click Start and then Run. Type in X:\setup, where X is the drive letter of your CD-Rom drive e.g. D:\setup. Click OK.

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2.4 Searching for the radio modules
At the start of Biofeedback 2000 x-pert all radio modules within reach are searched automatically and connected to the software. This requires that all radio modules are activated at the start of the program. If this is not the case you can search the devices manually after the start of the program. Use the magnifying glass symbol on the top right margin of the program to do this:

The radio module search function

You now have two options: Search for new devices: Searches the environment and connects with ALL devices that are present. The disadvantage is that the search takes longer. However, this method guarantees that all radio modules will be found. Search for known devices: Connects the software only with those radio modules that have been connected previously. The advantage of this option is that the search is significantly faster.

Click on Search for new devices or Search for known devices to search for radio modules.

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At the end of the search (which may take some time) the found radio modules are displayed in the Device list: In this example two radio modules were found.

2.5 Accelerate program start

Make sure that all the radio modules you own are listed in the Device list. That is if you have purchased three radio modules, three icons need to show in the Device list. Only then you may follow the following steps: Right click the search window:

In Program start select option Only search for known devices.

Biofeedback 2000 x-pert now starts much quicker because only known devices are searched. Should you be operating two parallel systems then the option Only search for known devices is obligatory anyway. Otherwise the system started up first would find and connect all the devices.

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2.6 Using more than one radio module of the same type
With Biofeedback 2000 x-pert you can use more than one radio module of the same type (e.g. two RESP modules can be used simultaneously). This is particularly useful in group sessions. If you have activated more than one identical module, the following message appears during the module search:

Click OK to confirm. You will then be able to assign device numbers to correspond to the descriptions given.

Set the device number and click OK. On the next page you will see a list of all the radio modules and the numbers assigned to them.

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3 Running a session
3.1 Initial settings
When you start Biofeedback 2000 x-pert the following screen appears:

Available treatment modules

Deactivated Buttons

To run a session, you must first select a form of therapy from the list given under Therapy modules. Detailed instructions for this type of therapy then appear under Description. A form of therapy must be selected before the two buttons at the bottom of the window become active and enable you to continue. You can use the two lists of options under Session start/stop to choose how a session will be started and ended. If you want the session to begin as soon as Continue to start session is clicked or a client is selected, select Start: automatic from the centre list. If you select Start: manual you will need to start the session manually when you reach the session window. Selected therapy form

You can use the right-hand list of options to select how you want a session to be ended. The following four options are available: Choosing Stop: manual selection brings up the window described in Section 3.9. This lists all the options that can be pre-set. If you select Stop: show chart the chart of the session will be

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displayed, and you will then have the option to save the data. If you select Stop: save data, the chart will not be displayed but the data will be saved. A window will show the name of the file. Consider carefully before selecting Stop: discard data. If you choose this option, the data will be discarded at the end of the session - the session chart will not be displayed and the session data will not be saved.

When a therapy module has been selected (it is highlighted in blue), there are two ways in which you can proceed: If you click Continue to start session, the last client will be selected for the session which is now beginning. If you click Continue to select/new client you will be able to search the database for an existing client or enter details of a new one. Demands the Input or choice of a client Enables the direct start with the last client

If you want to enter or select a client, the following screen will open.

You can select an existing client from a list (Select client), or call up the record of the last client (Last client) or create a record for a new client (New client). For a new client you can edit the fields or store comments under "Notes". Once the selection has been made or data entered, click OK. You will be taken to the selected form of treatment.

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3.2 Starting a session
When you open a session the top of the program window looks like this:

Start Session Click the start icon (the green man) to begin the recording and display of the parameters being measured. During the session you can use the taskbar at the bottom of the screen to change the measurement channels being displayed:

Summary of the measured parameters: SCL .............. Skin Conductance Level tonic level of skin conductance SCR .............. Skin Conductance Response brief (phasic) variation in electrodermal activity, usually in response to a stimulus EMG-1 ......... Electromyography channel 1 EMG-2 ......... Electromyography channel 2 EEG-1 ......... Electroencephalography channel 1 EEG-2 ......... Electroencephalography channel 2 EKG .Electrocardiogram RR Time between R peaks in the EKG (reciprocal of the pulse rate) TEMP-1 ....... Skin temperature channel 1 TEMP-2 ....... Skin temperature channel 2 RESP-1 ........ Abdominal respiration abdominal respiration curve RESP-2 ........ Thoracic respiration thoracic respiration curve RSPA ........... Respiration amplitude depth of respiration RSPF ............ Respiration frequency BVP .............. Blood volume pulse pulse component of the surface blood flow PVA .............. Pulse volume amplitude amplitude of the blood volume pulse PULS ........... Pulse rate MOT ............ Motility movement/activity MICRO ........ Microphone variations in speech patterns; ambient sounds The Marker button enables you to type in text relating to events that occur during the session. Press the Return key to close the input window.

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3.3 Selecting the measurement channels

settings bar

scaling field

selection of active data display

data bar

You can use the buttons on the data bar to select the data that will be displayed on the screen. In the above example these are the readings EMG1 and EMG2 from the EMG module, Resp1, RespA1 and RespF1 from the RESP module and SCL from the MULTI module. To display other data, simply select the required items on the data bar. If none of the readings from a particular module are required, it is not necessary to deselect each one individually - the whole module can simply be deactivated. In this example the RESP module R has been deactivated, which means that Resp1, RespA1 and RespF1 have also been automatically deactivated.

This method of deactivation has the advantage that the most recent settings are retained when the radio module is re-activated. In this particular example Resp1 and RespF1 will be displayed upon reactivation. The radio module buttons on the bar at the bottom of the screen include a battery state indicator. The illustration on the left is enlarged and shows an EMG module with a battery that is approximately 70% chaged.

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To select channels before the start of the session, move the mouse over the label below the radio module icon. The selected channels will be activated on startup. If you deselect a channel, the session window will not offer you the option of activating it. Nothing will be recorded from that channel. If you deactivate a channel during a session, it will not be displayed, but the channel will be recorded and you will be able to include its data in the session chart.

When the mouse pointer is placed on the arrow below the icon, the modules selection window opens.

3.4 Requesting data

You can use the bottom bar to request the current data. Simply move the mouse pointer to the button corresponding to the data you are interested in. This brings up a colored window containing the data.

Another way of requesting data is described in the next section.

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3.5 Settings in the data window
To help you tailor the Biofeedback data windows to your particular needs, you can use the right mouse button to change the settings. Right-clicking in the measurement windows brings up the following screen: If you choose this option, the current settings will be used as the starting point for future sessions Show/hide these fields Select a data window

Change the color of a measurement channel

Battery state In Settings you can make a number of changes to your data window. These are described in more detail below. If you want to display two sets of data Display in one chart, you should check that they fall within the same range. You should also turn off autoscaling of the data. If you place the mouse pointer on Battery level, a percentage figure will indicate the amount of charge remaining in the battery of each active radio module, as shown in the illustration. If you want the actual data values to be continuously displayed in number form, you can select Display measurement window. All available measurement channels will be listed and you can select all the data that you would like to have displayed in number form.

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3.6 Scaling of readings
The line display is always scaled automatically, so that the most useful view is always presented. The scaling can, however, be altered manually using the sliders on the left-hand side of each measurement window. Arrow for the upper measurement range.

The circle in the center indicates the current location of the reading. Arrow for the lower measurement range.

Automatic scaling can be turned off completely by double-clicking on the slider itself:

When automatic scaling is turned on, the arrows at the top and bottom of the slider are green. To turn off automatic scaling, doubleclick on the slider.

The arrows turn red, indicating that automatic scaling has been turned off. To turn on automatic scaling, double-click until the arrows turn green.

Note: If automatic scaling is turned off, the client should not be left alone during the session; the lines could disappear from the measurement windows since scaling is not being automatically adjusted. If you change the scaling without turning off automatic scaling, the scaling gradually readjusts during the session to the clients reaction profile.

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To adjust the slider manually, move the upper and lower arrows:

Here the upper arrow has been moved down to Here the lower arrow has been moved upwards 10. The line window now displays the range (to 8). The line window now displays the from 0 10. range from 8 10.

For the training forms that use pictures (volume feedback, faces, puzzle, sun etc.) the slider arrows are yellow and there is no automatic scaling. Scaling must be adjusted manually to the clients reaction profile. Increasing the sensitivity of the display: If the clients reaction profile is low, it may be necessary to increase the sensitivity of the display in order to obtain sufficient feedback. This is done by reducing the extent of the range i.e. by moving the upper arrow downwards and the lower one upwards.

Decreasing the sensitivity of the display: If the client has a strong reaction profile, it may be necessary to decrease the sensitivity. This is done by increasing the extent of the range - i.e. by moving the upper arrow upwards and the lower one downwards.

3.7 Providing acoustic support

A number of different options are available:

audio feedback

volume control

music from the PC

voice recorder playback voice recording

music from a CD

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3.7.1 Audio feedback This function provides acoustic feedback on readings, for example in the form of a tone that gets higher as EMG values rise. The function can be turned on or off using the left mouse button. The right button is used to select the parameter (e.g. respiration or skin conductance) that will be linked to the tone.

Here the audio feedback is controlled by Respiration curve 1.

Here the sensitivity of the feedback can be adjusted to the clients depth of respiration.

3.7.2 Music from the computer This is simply background music. Six music tracks are supplied with the software. They can be turned on by clicking with the left mouse button. Clicking with the right mouse button enables a different track to be selected. 3.7.3 Music from a CD This function enables any audio CD to be played as background music. 3.7.4 Voice recorder This function enables conversation during the session to be recorded. The switch must be turned on BEFORE the start of the session. 3.7.5 Voice recorder playback This function is used to play back a speech file recorded during a previous session. 3.7.6 Volume control The volume of the selected function can be adjusted here.

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3.8 Settings using the bottom bar
Some settings can be selected by moving the mouse pointer over the bottom bar and rightclicking. The following illustration shows the options that become available when the mouse pointer is placed over a device icon. Right click on the RESP (R) module

An important option is the one that enables you to calibrate a radio module. This can be done for the RESP and MULTI modules but not for the EMG module as this does not need to be calibrated. You can also switch all the channels of a radio module on or off. This has the same effect as left-clicking on the device icon.

Right mouse button at the channel EMG1

Right-clicking on a measurement channel (the EMG1 channel in this example) enables you to turn on the data window and - analogous to the previous point - to switch all the channels on or off. You can also activate the selected channel's line graph and temporarily change the channel color. These settings will be used only during the current session.

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3.9 Ending a session
Click Stop to end or pause the session.

Click here to end the session

Click Display the diagram to evaluate the session or Continue the session to continue recording.

You can pause treatment by clicking on Stop and then on Continue the session. Clicking on Display the diagram means that the session is immediately evaluated.

Save the data without diagram display can be used during sessions that will not be evaluated until later. End the session and discard the data can be used if an error has been made and the session needs to be re-started as quickly as possible.

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4 Chart and evaluation
In the chart display screen you can compare the session with previous sessions (select required charts from the database), and enlarge or print the chart. If "Close chart" is selected, you will be asked if you wish to save the data. A detailed description of the chart functions can be found in Online Help.

Close chart Select whole chart sequence Enlarge selected chart sequences

Switch between bar, lines or 3D display

The Info field can be used to add statistical data to the chart

Show/hide data (then click Update in the bottom right-hand corner)

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You can choose the form in which the information is to be displayed. In this example a 3D display has been selected:

Click here to set the type of display.

Select here which general shape the display should have.

Select the specific shape here.

Move the mouse pointer to the slider to get the respective channel in the foreground.

Move the mouse in the display area while holding the left mouse button to turn the 3D display on all axes.

The Diagrams one above the other function displays the individual diagrams in separate fields. The function Use shared axis displays all the diagrams in one pane (e.g. for evaluating EMG comparison training).

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4.1 Evaluating heart rate variability
When the BFHRV software module is enabled and the parameters RR and EKG have been recorded with the EXG module, the button for the HRV report (red heart) becomes active.

Select the HRV report here. A comprehensive evaluation is then displayed. This has been developed for statistical applications and only a small part of it is relevant to verification of a BFB training session:

The two Hier den graphs HRV-Report at the top are used to check whether the auswhlen. signal is free of artefacts. SDNN should increase from session to session. A value over 100 indicates adequate heart rate variability. The peak at 0.1 Hz shows the respiratory sinus arrhythmia.

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4.1.1 Description of the statistical parameters
For an in-depth account of the HRV parameters and their significance the user should consult the relevant literature or the Internet. Only a brief summary can be provided here.

4.1.1.1 Si (Stress index)

The stress index calculated is that described by Prof. Baevsky, who developed and validated this parameter for use in Russian space medicine. The stress index is increasingly widely used because it responds sensitively to changes in the vegetative balance between the sympathetic and parasympathetic nervous systems. It is simply a mathematical description of the histogram:

Amo(%) Stress index = 2 Mo MxDMn

Mo = modal value (most frequent value of the RR interval) Amo = number of RR intervals corresponding to the modal value as a percentage of the total number of all readings MxDMn = variability width (difference between the maximum and minimum RR intervals) Because of its sensitivity, the stress index is useful for recording changes within a client over time. However, like all other HRV parameters it is strongly influenced by the overall state of neurovegetative regulation. This means that if the HRV is affected by an organic condition (e.g. as a complication of long-term diabetes), this will be reflected in a high to very high stress index without there necessarily being a concomitant level of stress.

4.1.1.2 HRV index

N HRV index = SiMax
SiMax = maximum value of the histogram

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4.1.1.3

SDNN (Standard deviation)

This parameter is a descriptive statistic that describes the degree of dispersion of readings about a mean. Since heart rate variability can be regarded as a statistical phenomenon (the heart rate fluctuates about a mean, with larger deviations from the mean being less likely than smaller ones), the use of the standard deviation has become standard practice in describing heart rate variability.
N 1 ( xi x ) 2 N 1 i =1

Standard deviation =

Reference values according to Lllgen: SDNN < 100ms: moderate decrease in HRV SDNN < 50ms: severe decrease in HRV

4.1.1.4 pSDNN (Variation coefficient, VK)

The variation coefficient combines the mean and standard deviation in one number.

SDNN 100 pSDNN = Mittelwert

The VK is given as a percentage. A VK of 10% means that 68.2% of the recorded heart rate lies within the range "10% of the mean. The higher the standard deviation or VK, the greater the heart rate variability.

4.1.1.5 RMSSD (Root mean square of successive differences)

The root of the mean of the quadratic differences of the RR intervals of successive heart beats. The RMSSD is somewhat complex mathematically, but it describes a simple concept: it indicates how much the heart rate varies from one heartbeat to the next.

RMSSD =

1 N ( RRi +1 RRi ) 2 N i =1

Artefacts are characterised by pronounced jumps in the heart rate. When artefacts are present the heart rate varies markedly from one heartbeat to the next. A high RMSSD combined with a comparatively low standard deviation or low variation coefficient indicates a need to check the recording for artefacts. Reference value2: 51.7ms A decrease in the RMSSD value indicates a reduction in parasympathetic activity.

An 43 gesunden Studenten erhobene Normwerte (Mittelwerte nach M. Mck-Weymann 2001, unverffentlicht). Hierbei handelt es sich um junge Bezugspersonen (Alter: 23,3 +/- 3,5 Jahre), was beachtet werden muss, da die HRV altersabhngig ist.

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4.1.1.6 SDSD (Standard deviation of the differences)
N 1 (RRi RR) 2 N 1 i =1

SDSD =

4.1.1.7 SAa (Absolute sinus arrhythmia)

Represents the mean of the differences between adjacent RR intervals.

1 N ( RRi +1 RRi ) SAs = N i =1

4.1.1.8 pNN50
The percentage of all adjacent NN distances that differ > 50ms from each other. Reference value3: 12.3 % An increase in PNN50 is an indication of increased parasympathetic activity.

4.1.1.9 pNN100
The percentage of all adjacent NN distances that differ > 100ms from each other.

4.1.1.10

SD1, SD2

SD1 and SD2 describe the spread of the heartbeats in the Poincar plot. SD1 describes the width of the cluster and is more sensitive to rapid, higher-frequency variations in heart rate, while SD2 describes the length of the cluster and is more representative of the long-term HRV.

1
SD1 =

SDSD

SD2 =

1 2 * SDNN 2 SDSD 2 2

Norms obtained from 43 healthy students (means taken from M. Mck-Weymann 2001, unpublished). The subjects are young people (age: 23.3 +/- 3.5 years); this must be taken into account, since HRV is influenced by age.

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4.1.1.11 The Poincar plot

A further method of analysing the HRV over time is to show the recorded values in a Poincar plot. This involves mapping the RR time series onto itself in an XY coordinate system; each RR interval is plotted as a function of the previous RR interval. In effect this shows the correlation between two successive RR intervals. The plot is evaluated visually, i.e. according to the shape of the resulting cluster. For normal individuals the cluster is typically comet-shaped. Torpedo-shaped or round clusters may indicate a reduced HRV. They are found, for example, in post-myocardial infarction patients but also occur if insufficient data is available (recording time less than 5 minutes).

Satisfactory distribution

Recording with artefacts (The scattered values, at a distance from the rest of the cluster, indicate erroneous measurements).

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4.1.1.12 The histogram

The histogram shows the frequency of RR intervals of different lengths. A histogram with a broad distribution indicates pronounced variability. The greater the range (SW), the greater the variability: 8% of all heartbeats have an interval of 900 milliseconds. Frequency of occurrence as a percentage.

Range (SW)

Interval between the individual heart beats in milliseconds (1000ms = 1 second).

4.1.1.13

The frequency bands

High frequency (HF) an important factor in parasympathetic activity occurs in the range between 0.15 and 0.4 Hz. This band reflects how the heart rate adapts to the respiration rhythm. The low frequency (LF) parameter represents parasympathetic and sympathetic influences; it lies in the range 0.04 0.15 Hz. Fluctuations in this band are known as Mayer waves (periodic oscillations of the arterial blood pressure as a result of rhythmic contractions of blood vessels that offer resistance to blood flow). Very low frequency (VLF) occurs in the range 0.003 0.04 Hz and provides information about the sympathetic system. It is described as corresponding to skin conductance. A ratio between sympathetic and parasympathetic activity (HF/HF) of 1.5 2.0 is regarded as normal. Higher values indicate that the sympathetic (i.e. activating) nervous system is excessively active.

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5 Program control
The program control window provides seven options on different tabs: Database, Settings, Therapy library, Session preselection, Modular interface, Sensor position, Help and Info.

5.1 Database
5.1.1 Open diagram/database In the upper part of the database window you can select a client. The lower section lists the charts already saved for that client.

1. Select a client from the list

3. Display diagram 2. Select a chart

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5.1.2 Select/new client This window opens before the start of each session.
Select client brings up an alphabetical list of your clients. You can make your selection by double-clicking or by clicking OK. New client enables clients to be added to the database. The OK button saves the new data. Notes about the client (e.g. diagnosis) can be inserted via Notes; if required, this can be done before the session.

5.1.3 Copy data Enables session data to be transferred between different computers (using CD-Rom or floppy disk). 5.1.4 Call up statistics module The statistics module enables an intelligent reduction of data with many possible options. It also simplifies the import of data into Excel and SPSS. 5.1.5 End program Ends Biofeedback 2000 x-pert.

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5.2 Settings

This tab provides options for modifying program settings.

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5.2.1 Basic settings
You can use the Basic settings menu to define the hardware settings. Via the General tab you can set the intervals at which data will be saved on the hard disk. You can also select the language and define the directory in which the subject's data will be stored.

The Use Feed-forward option can be used to adjust a client's data in either a positive or negative4 direction. The values actually recorded are adjusted in the required direction in accordance with an instruction set by you. Experiments have shown that the success of biofeedback training increases when the client feels that he is performing well in training5. When the client's motivation has been strengthened in this way the use of the feed-forward function can be dropped. The values selected for the feed-forward function can be different for each channel. The feedforward function is defined via the Recorder - Setup tab for the relevant channel. When the Generator is activated all actual readings are ignored and feedback, whether in graph or picture form, is based on randomly generated values. This means that the client receives only simulated feedback. (This can be used, for example, in controlled group studies.)

The function is pre-set in such a way that the session always appears to be successful. If you want to change the trend, the plus/minus signs of the relevant values needs to be reversed. Schandry, Rainer : Lehrbuch Psychophysiologie, Psychologie Verlags Union, Weinheim, 1996.

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Via the Hardware tab you can view the possible hardware types together with details of the version, type and connection of the Physio Recorder, radio modules, marker cable (Vienna Test System) and relay connection (to control a toy).

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The final tab is Recorder - Setup. Here you can change hardware settings such as sampling rate, feed-forward or standard channel color. The Standard button can be used to set the altered parameters as the new default settings. All tabs can be opened from the program control window by right-clicking on the required radio module.

Selecting the EMG icon takes you directly to the default settings for this module; selecting RESP opens the settings for the RESP module; selecting MULTI opens the settings for the MULTI module.

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Under MULTI you will find the settings available for the Multi radio module. From this screen you can set the sampling rate, feed-forward and color. To set the color of a channel, click with the left mouse button on the color field next to the channel whose color you want to change. This opens a second window where you can set the color.

The colors 1 to 16 correspond to the channels. Color 1 always relates to the channel of the first radio module. If you have a second Multi module, the SCL channel of radio module 1 will be assigned color 1 and the SCL channel of radio module 2 is assigned color 2. If you have additional modules, the list is continued. In the case of the EMG module the situation is slightly different as this module contains two channels. If you use a second EMG module, channel 1 of the second module will be assigned color 3. As default, two different colors are always defined for each parameter. If group sessions are to be carried out using several modules of the same type, it is advisable wherever possible to use colors that can readily be distinguished from each other.

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Under the RESP tab you will find the settings for the RESP radio module. This window is used in the same way as that for the MULTI module.

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For the EMG module, in addition to the settings for sampling rate, feed-forward and color, you can also set the sensitivity level and the frequency band within which measurement will be carried out. The sensitivity level enables you to adjust the maximum amplitude of the reading to the training goal. For relaxation training, select a high level of sensitivity (low final value). For strength training select a low sensitivity level, thus increasing the measurement range. The measurement range is selected from the EMG Sensitivity list under Additional functions. Seven different measurement ranges are available. For EMG modules you can also select the frequency range in which measurement will be carried out. This enables training to concentrate on slower muscle fibres or on faster ones, as required. The frequency range is selected from the list under EMG Filter; four different frequency ranges are available.

Filter setting

Sensitivity setting

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On the EXG tab you will find the settings for the EXG module. Options include settings the colors of the individual channels and the sensitivity of the module.

Sensitivity setting

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5.2.2 Set chart

On the Display tab you can choose between bar-chart or line display and set the associated parameters. By selecting Equal display area for channel pairs you can, for example, display EMG1 and EMG2 in the same measurement range, thus making it easier to compare the two.

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On the Info tab you can define how data will be displayed in the evaluation chart.

Under Marker options you can define specific settings related to the placing of markers. The marker options are described in more detail in Chapter 5 and in the Online Help.

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5.2.3 Set stress test On the General tab you can select the background picture. A picture preview is offered. In addition you can activate or deactivate the countdown in the preparatory phase, the picture of the bomb and the ticking sound. Under Time settings you can define the length of the different parts of the session.

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5.2.4 Access authorisation

Three different security levels are available for the use of the program:

Security level 0:

This is intended only for the administrator. Important! This password grants unlimited access to the software. Security level 1:Sessions can be run, but no settings can be changed. All existing settings are retained. This is a display function only. No data can be changed and no new session can be run.

Security level 1:

Security level 2:

When a new password is entered it is confirmed in the following line. A password can be deleted by entering the old password and leaving blank the fields New password and Password confirmation. Don't forget your current password. Without the password the program cannot be used. If the password is forgotten the program will have to be re-installed.

5.2.5 Software module Entering the correct licence numbers (from the floppy disk supplied) enables your software modules. Without licence numbers the program functions only in demo mode.

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5.2.6 Therapy library At the time of going to press the following treatment modules are available:
Module abbreviation BF Module name Basic module Functions Therapy library Multifeedback Threshold training Acoustic feedback Background music from CD or PC Sensor positions Connection to the Vienna Test System database Respiration training devised by Dr. Marx Essential hypertonia (1) Relaxation training Black screen, pictures, morphing, face Picture sequence display Desensitization Synchronous speech recording during the session.

BFRESP

Respiration

BFEDA BFKON BFREC

EDA relaxation training Confrontation training Voice recorder

BFMUSK

Neuromuscular rehabilitation Electromyography

Neuromuscular trainingIncontinence training

BFEMG

BFEEG BFHRV BFVASO

BFSTR

BFBEL BFSTAT

EMG relaxation training Tension headache Cervical syndrome Back pain Electroencephalography EEG screening EEG training Heart rate variability Heart rate variability training Evaluation of heart rate variability Blood circulation Raynaud's disease Essential hypertonia (2) Migraine Activation Psychophysiological response profile as evoked by standardized screening "physical" stressors (stress test) Tolerance test Recording of psychophysiological parameters in a stress situation Statistical module Data filter, artefact correction, smoothing, isolation of time periods, data reduction, comparison of sessions and individuals

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Brief description of treatment options: Line-graph (Multifeedback) Feedback from one or more parameters This function can display any selected parameters either singly or in combination. The function can be used either for the simple recording of data or for training (for the initial sessions with a client the line-graph display is often the most appropriate form of feedback). Events during the session (baseline, start of training etc.) can be highlighted by means of notes, facilitating the subsequent evaluation. Parameters can be turned on or off during the session. Scaling of the line(s) on the display takes place automatically, so the display is always optimally adapted to the client's response profile. Respiration training Changing habitual dysfunctional patterns of breathing This procedure, developed by Dr. Rudolf Marx, uses the display of an ideal respiration curve to help the client acquire an efficient and correct style of breathing. The computer analyses the current breathing pattern and from this calculates the ideal respiration curve. This enables the client's original breathing pattern to be gradually changed. Recommended session length: 10 mins. Notes: To avoid making undue demands of the client, particularly at the beginning of training, the respiration rate should be reduced only by small steps. After several training sessions, the client should find that the rhythm learned in training is easy to use even when the ideal respiration curve is not displayed. This should be checked after a maximum of five training sessions by using the Line-graph (multifeedback) function. When the client is able to use the new breathing pattern, a decline in sympathetical activity (in comparison with earlier sessions) will be observed. RESP relaxation training Relaxation through concentration on respiratory movement This training method is particularly suitable for inducing relaxation. Information on respiratory movement is fed back to the client either visually or acoustically. Recommended session length: 20 mins. Feedback options: Bar: the respiratory movement causes a bar or a picture on the monitor to become bigger or smaller. Audio feedback: the respiratory movement alters the pitch of a musical note. The client is instructed to close his eyes and concentrate on the feedback from his breathing.

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EDA relaxation training Reduction of sympathetical activation The feedback of information about skin conductance aims to reduce the habitual level of arousal and of sympathetic nervous system activity. Recommended session length: 15 mins. Feedback options: Line-graph (Multifeedback) The skin conductance level (SCL) is displayed in line-graph form. Face: Through relaxation the client attempts to make the face on the screen smile. Morphing: For example, a lowering of the skin conductance level makes a caterpillar turn into a butterfly. Pictures for children: The change in SCL is displayed in a form especially designed for children. Audio feedback: With closed eyes, the client attempts to lower the frequency of an audio signal. The deeper the note, the lower the level of sympathetical activity. Confrontation Desensitization using visual stimuli Phobia-inducing pictures are shown on-screen during the session, producing an arousal or anxiety response. The client can observe the reactions of his autonomic nervous system under extreme conditions and attempt to control them. Using feedback of the physiological components of the client's anxiety response, the therapist can help the client develop strategies for dealing with these responses. An additional option is the use of systematic desensitization, as the picture material is graded according to how threatening or dangerous its content is perceived to be. Recommended session length: 10 mins. Suggestion: Photograph scenes that the client experiences as threatening and scan the pictures in. In this way picture series can be built up that are significant for individual clients. Voice recorder Identification of dysfunctional cognitions While taking a case history, the conversation itself is recorded alongside the physiological parameters. At the end of the session the therapist can analyse more closely the topics that led to increased reactivity in the autonomic nervous system. Recommended session length: 20 mins. Note: To avoid distraction during the conversation, the client should not be able to see the monitor screen. The therapist should, however, occasionally check the recording of physiological parameters to make sure that no problems arise during the session or the subsequent discussion. EMG relaxation

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Muscle tension reduction A fall in muscle tension is accompanied by a reduction in the activity of the sympathetic nervous system. This training can therefore also be used for general relaxation. Recommended session length: 15 mins. Feedback options: Threshold training: Using a bar - which can be adjusted during the session - a target value is set for the client. If he succeeds in getting the recorded muscle tone to fall below this target level, he receives a reward (e.g. music or stories are played). Audio feedback: The client receives acoustic feedback from the electromyogram of the musculus frontalis. With closed eyes the client attempts to produce as deep a note as possible. TEMP training Raising the skin temperature One of the most reliable signs of physical relaxation is the sensation of warmth in the hands. The client is taught how to warm his hands. Imaginative techniques can be very useful in this context. Recommended session length: 15 mins. Feedback options: Sun: Warming of the hand is linked to the simulation of a sunrise on the screen. Line-graph (multifeedback): Temperature changes are shown on a line graph. Threshold training: The training goal (e.g. raising the hand temperature by 0.5 C) is represented by a target bar. If the client achieves the goal, music is played or a story told as a reward.

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Neuromuscular rehabilitation Training for neuromuscular deficiencies The client is taught how to contract appropriate muscle groups, following a displayed curve. This both increases the client's ability to control specific muscles and develops the muscles themselves. Recommended session length: 10 mins. Note: At the start of treatment the contraction phases should be kept relatively short in order to reduce the stress on the client. EEG screening Analysis of the EEG frequency profile FFT frequency analysis (Mind Mirror) can be used to identify dominance in different sides of the brain or in different frequency bands. Note: Training forms for the EEG can be found under the Modular interface tab.

Assignment of individual frequency bands: Beta and HBeta: Beta EEG (15 - 30 Hz) When: physical and mental activity. Where: occurs precentrally and frontally. Therapy: increase in cases of ADS and hyperactivity SMR: sensomotor reaction (12 - 15 Hz) When: Motor activity. Where: occurs occipitally and parietally. Therapy: increase in cases of ADS and hyperactivity Alpha: Alpha EEG (8 - 12 Hz): When: in state of relaxed wakefulness. Where: occurs occipitally and parietally. Therapy: to induce relaxation Theta: Theta EEG (4 - 8 Hz) When: in state of drowsy wakefulness. Where: increased occurrence in frontal and temporal areas. Therapy: decrease in cases of ADS and hyperactivity Delta: Delta EEG (0.5 - 4 Hz) : When: Occur primarily in phases of deep sleep. Where: occurs in various areas.

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Incontinence training Strengthening of the pelvic floor muscles A vaginal electrode is used to record contractions in the pelvic floor muscles; the reading is displayed on the monitor in the form of an electromyogram. Specially targeted training, using contraction and relaxation phases, leads to a gradual strengthening of the affected muscles and to a reduction in symptoms. Recommended session length: 10 mins. Note: The default settings (contraction: 3 sec., relaxation: 4.5 sec.) have been selected to coincide with the training rhythm for relaxed breathing (if appropriate display the readings from RESP-1). Migraine (1) Vasoconstriction training This training method uses the pulse curve recorded from the temporal artery. The goal of a training session is to reduce the pulse amplitude as much as possible. Recommended session length: 15 mins. Feedback options: Volume feedback: A red circle symbolizes the diameter of the temporal artery. The client is encouraged to make the circle as small as possible and to maintain the reduced size for as long as possible. Line-graph (multifeedback): Changes in blood flow are displayed in line graph form. Essential hypertonia (1) Respiration training In many clients with essential hypertonia it can be observed that the exhalation phase of breathing is shortened. Where this is the case, it is advisable to carry out respiration training to ensure that the client has adequate coping strategies at his disposable, particularly when exposed to stress. In addition, relaxation and efficient breathing lead to the development of a respiratory sinus arrhythmia (RSA). Recommended session length: 20 mins. Note: The client should be instructed to breathe in accordance with the displayed ideal abdominal respiration curve and to concentrate particularly on the exhalation phase. If this is achieved without exertion, respiratory sinus arrhythmias will be observed in the heart rate feedback (the heart rate increases during each inhalation phase and falls again on exhalation). This is a general indication of the flexibility of the cardiovascular system.

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Cervical syndrome (pain and stiffness in the neck) Reduction in the tone of the trapezius muscle The goal of training is to reduce the recorded value and/or to reduce the difference in muscle tone. Recommended session length: 20 mins. Feedback options: Comparative value training: By taking readings from both sides of the trapezius the client can be given information about the difference in muscle tone. Threshold training: Only EMG-1 is used. A bar can be used to set a target value for the client. If he succeeds in getting his muscle tone to fall below this level, he receives a reward (e.g. music or stories are played). Line-graph (multifeedback): An additional option is to use only one EMG channel for the reading from the trapezius and to use the other channel to record the muscle potential of the sternocleidomastoideus (see the Sensor positions tab). Tension headache Reduction of tone in the musculus frontalis Indication: muscle potential in the musculus frontalis exceeds 3V. Session goal: reduction in muscle tone to less than 1.5 V. Recommended session length: 20 mins. Feedback options: Threshold training: A bar is used to set a target value for the client. If he succeeds in getting his muscle tone to fall below this level, he receives a reward (e.g. music or stories are played). Audio feedback: The client receives acoustic feedback from the electromyogram of the musculus frontalis. With closed eyes the client attempts to produce as deep a note as possible. Back pain (muscularly induced distortion of the spine) Reduction in tone of the erector muscle Two EMG channels are used. The electrodes are placed to the right and left of the spine level with the site of the muscular tension or pain (see the Sensor positions tab). The aim is to achieve both a reduction in recorded values and a minimizing of the difference between the two EMG channels. It is also possible to request the client to take up different physical positions, to identify these with markers, and to analyse them in the subsequent discussion of the session. In which positions did pain appear? Recommended session length: 20 mins.

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Tinnitus Feedback of the electromyogram of various muscle groups EMG relaxation training is recommended for the treatment of tinnitus. Depending on the initial diagnosis and the exact site of the problem, readings can be taken from the masseter, trapezius or sternocleidomastoideus muscles. This should ideally be combined with progressive muscle relaxation in order to ensure a generalization of the relaxation effect. Recommended session length: 15 mins. Feedback options: Line-graph (multifeedback): The recorded parameter is displayed on a line graph. The aim is to achieve a reduction in muscle tone. Threshold training: A bar is used to set a target value for the client. If he succeeds in getting the recorded muscle tone to fall below this target level, he receives a reward (e.g. music or stories are played). Audio feedback: The client receives acoustic feedback about the electromyogram. With closed eyes the client attempts to produce as deep a note as possible. Bruxism Recording of the electromyogram from the masseter muscle and adjacent muscle groups day-time (diurnal) bruxism: EMG relaxation training using line-graph feedback. night-time (nocturnal) bruxism: EMG feedback with threshold training. The biofeedback system records the muscle potential of the masseter during sleep. If the readings exceed a pre-set threshold, the computer gives an audible signal and the client wakes. Recommended session length: 15 minutes (or for the duration of a period of sleep). Feedback options: Line-graph (multifeedback): The reading from the masseter muscle is displayed on a line graph. The aim is to achieve a reduction in muscle tone. Threshold training: A bar is used to set a target value for the client. If the recorded muscle tone exceeds the target level, an alarm or other warning is sounded. Audio feedback: The client receives acoustic feedback from the electromyogram of the masseter muscle. With closed eyes the client attempts to produce as deep a note as possible.

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Raynaud's disease Handwarming training with localized exposure to cold stimuli Raynaud's disease is triggered by hyperactivity and vasospasm of blood vessels in the skin as a result of exposure to cold and/or emotional stress. The first step should be to carry out normal handwarming training. Subsequently the client should attempt to maintain vasomotor control in temperature conditions that normally trigger the symptoms, since the peripheral vasospasm usually occurs when the ambient temperature is low. Recommended session length: 20 mins. Feedback options: Sun: Warming of the hand is linked to the simulation of a sunrise on the screen. Line-graph (multifeedback): Temperature changes are shown on a line graph. Visual stimulus presentation: The client is shown pictures of cold things (e.g. snow scenes) while being asked to raise the temperature of his fingers. This function is only available when used with the Confrontation module. Essential hypertonia (2) Handwarming training The goal is a reduction in sympathetical activation. One of the most reliable signs of physical relaxation is the sensation of warmth in the hands. These feelings are a consequence of vasodilatation (widening of the blood vessels) in the extremities, which leads to a fall in blood pressure. Alongside the classic handwarming training it is worth using relaxation training, respiration training, and a lowering of the resting pulse. Recommended session length: 15 mins. Feedback options: Sun: Warming of the hand is linked to the simulation of a sunrise on the screen. Line-graph (multifeedback): Temperature changes are shown on a line graph. Migraine (2) Handwarming training Temperature feedback from the non-dominant hand is used to help the client acquire control over his vasomotor activity.
A combination of temperature feedback and relaxation training is particularly effective and should be combined with detailed recording of attacks and medical investigation of the symptoms.

Recommended session length: 15 mins.

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Feedback options: Sun: Warming of the hand is linked to the simulation of a sunrise on the screen. Line-graph (multifeedback): Temperature changes are shown on a line graph. Note: An additional temperature sensor can be placed over the temporal artery to provide a comparison with the hand temperature. The aim is to raise the temperature of the hand while lowering the temperature at the temples. Stress test Psychophysiological diagnostic tool During exposure to a stressful stimulus (visual and acoustic) all the client's physiological parameters are recorded. The subsequent evaluation reveals the vegetative systems (cardiovascular, electrodermal etc.) which show the most marked response for that client. In addition, the timing of responses yields information about psychological processes such as anticipatory anxiety. Test length (pre-set): 6 mins. Tolerance test Psychophysiological diagnostic tool During a session the client, using clicks of the mouse, has to make judgements about the shape, color and acoustic pitch of a moving geometric shape. The computer continuously monitors the clients performance and adapts the difficulty of the test accordingly (adaptive test), thus subjecting the client to the optimum level of persistent stress. The psychophysiological components of the client's responses can subsequently be evaluated. Test length (pre-set): 3 mins.

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5.3 Session preselection
You can use this tab to run sessions in non-standard ways.

Click Continue to start the session.

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5.4 Creating a modular screen
On the tab Modular interface you can create individual training screens of your own. To create a new training screen, click on Blank screen and then on Continue to start the session.

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A blank session window will appear. Right-click on the blue background. This opens a list of the objects that can be displayed.

Here a video player can be brought to the individual screen.

Here you can select from four different objects.

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For example, a specially devised screen might look like this:

Here a line graph was positioned to display the parameter SCL as a line.

Here you can set which video should be played as a reward.

Here a video player was inserted to reward the client by showing a video after he reaches a particular training goal. With a right mouse click the player can be hidden so the client only sees the video.

Here two measurement windows are displayed to show the parameters SCL and Temp as a value. Here two bar chart were positioned to display the parameters SCL and Temp in the shape of a bar.

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Right-click on the blue background to save the training scheme you have created.

A pop-up menu will open; click on Save as

You can now give the screen a name and add comments if required.

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5.5 Using a modular screen
Once you have created a new treatment form, it will appear in the list of modular screens.

Here the self-made training form is displayed.

Here the channels required for the training are displayed.

Here the selected therapy form is started.

To delete screens that you have created, right-click on the name of the screen. In the above example, right-clicking on SCL and Temp would delete this item.

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5.5.1 Pre-prepared EEG screens
Seven pre-prepared EEG screens are already included in the Modular interface. To open these screens an EEG module must be in use and the appropriate channels must be activated (e.g. the Alpha 1 channel for alpha training). Select one of the treatment forms and click on Continue to Start the session. For example, for Theta/Beta training the screen appears as follows:

Here the EEG raw graph is displayed in order to verify whether a valid signal is measured.

Here the frequency spectrum of the signal is displayed.

By moving this threshold the Theta value which the client needs to fall below can be set, for the video to start.

By right clicking with the mouse on the video screen you can set which video is shown.

By moving this threshold the Beta value which the client needs to exceed can be set, for the video to start.

By altering the thresholds it is possible to set when the video is played (as a reward for the client) and when it stops. The video always plays when all the conditions have been met. In the above example the video will play when the theta reading falls below the defined threshold and the beta reading is above the set threshold.

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5.5.2 Heart rate variability training
Three pre-prepared screens for HRV training are provided in the modular interface. An EXG module is needed to carry out the baroreflex training. For the other two training forms (RSA and coherence training) an EXG and a RESP module are required. The sequence of a baroreflex training session is described below:

1) Click on the Modular interface index card.

2) Select HRV Baroreflex training

3) Click on Continue to start the session.

The session screen then opens:

4) Start the session by clicking on the green man.

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A successful baroreflex training session is depicted below: 2) The client is instructed to breathe to the rhythm of the blue bar (6 breaths per minute). 3) Shortly after the start of training the pulse rate should assume a sinus shape.

1) This window checks whether a valid EKG signal is being received (e.g. to check that the electrodes are properly attached).

4) The amplitude of 0.10 Hz depicts the respiratory sinus arrhythmia in the frequency window and is evidence of successful training.

Click the Stop symbol to end the session. For notes on evaluation see page 23.

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5.6 Selecting modular objects
The software currently supports five modular objects: line graph, bar-chart, data window, frequency analysis, video player. These objects can be positioned anywhere on the screen (including on a second monitor). To call up one of the objects, right-click in the measurement window:

Right click the mouse in this area (measurement window).

Call up the video window here.

Save the changed screen here.

Select the desired object here.

Select the desired parameter here (e.g. SCL, Temp etc.)

Once the object has been selected it can be positioned anywhere on the screen. If you want the object to be in this position each time the measurement window is opened, click on Use current settings as standard settings.

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5.6.1 Line graph The small line-graph window displays the selected parameter in line form.

The display settings can be changed by right-clicking on the line window.

Display range defines how quickly the line is drawn i.e. what time range is shown in the window.

5.6.2

Data window

This small window displays the recorded value as a number. By right-clicking on this window it is possible to change the size of the font in which the reading is displayed.

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5.6.3 Bar-chart If this object is selected, the reading is displayed in columnar form:

In the Modular interface a threshold can be set for the bar chart. This threshold determines when the video will be played as a reward. To set the threshold, right-click on the bar-chart. Click on Threshold and then on Exceeds if the client is to be rewarded when a particular value is exceeded. If the client is to be rewarded when the reading falls below the pre-set value, click on Falls below.

5.6.4 Video player The video player has two different functions.
1. Playing videos as a reward. The video is played when the client achieves the levels set as the bar-chart threshold. This function is only available when used with the Modular interface. This function is only available with purchase of the BFEDA or BFEEG module. 2. Playing of confrontation videos. This function is used to play videos for desensitization purposes (e.g. when treating fear of snakes, fear of flying etc.). A feedback form (e.g. line-graph) is selected and the video player displayed (BEFORE the start of the session). During the session the client is shown the video and he practises, for example, keeping the SCL down. This function is only available with purchase of the BFVID module. Right-click on the video player to display only the video without the video player. Right-click again to display the whole player.

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5.6.5 Frequency analysis
This window has been specially developed for the EEG and EKG. By right-clicking on the object it is possible to set the form in which the frequency analysis is displayed: The green triangle of the slider was moved to the very bottom here so the modulation in the bar display becomes visible. Frequency analysis as Bar chart (two channel). This type of display is used e.g. to compare the activity of the right and left hemispheres. Note the color scale: black means 0 V, yellow means 0.15 V.

Frequency analysis as Color chart 2D. Bright colors indicate high activity. Dark colors indicate low activity. In the above example the highest activity is taking place in the 5 Hz range (shown in yellow). The green triangle of the slider was moved to 0.159 V.

Frequency analysis as Color chart 3D (45 to the right). In this type of display activity is represented both by the colors and by the undulations (peaks and troughs).

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5.7 Sensor position
In this window you can select the pick-up method and the position of the sensors. An illustration confirms your selection and helps you position the sensors correctly.

Select the desired form of sensor application here.

Select the exact position of the sensor application here.

5.8 Help
The Help documents contain a detailed description of the program. Therapeutic assistance provides general information on biofeedback, while Technical assistance covers software-related topics; both will increase your understanding of the system. Online help is available from the User interface. Info and Update Information contain general Information about the software and software maintenance.

Under Security notice you will find important information about security issues relating to the use of biofeedback.

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6 Connecting the VTS and Biofeedback 2000 x-pert
This function makes it possible to record and evaluate physiological data while using the Vienna Test System (VTS) to administer a psychological test. Two computers are required, one for the VTS and one for Biofeedback 2000 x-pert, connected by a marker cable.

VTS
marker cable
serial interface

BIOFEEDBACK 2000 x-pert

serial interface

USB interface

Radio Pyramid

dongle response panel light pen interface

radio modules
with integrated Bluetooth

Diagram showing the system set-up

Note: This function is included in the basic module and is automatically activated when a marker cable is connected to the serial port. You have to click on Search for new devices after connecting the marker cable. The marker icon then has to show in the device list:

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6.1 Preparing and running a session
Before commencing measurement of the physiological parameters you will need to: 1. Connect both computers via the serial port using the marker cable. 2. Start a Biofeedback 2000 x-pert session. Select Line-graph (Multifeedback) from the therapy library and enter the client data to do this. Click on Continue to start the session. 3. Start the desired test in the Vienna Test System. The biofeedback software automatically recognizes the start of the test procedure; the first marker appears on the screen at this point. After the test has ended, stop the physiological recording by clicking the Stop button. Switch to the chart display.

6.2 Evaluation
6.2.1 Session evaluation with time markers

You can use the Info field to add statistical data to the chart.

At the top of the session evaluation window are the rows of markers transmitted by the Vienna Test System. Each vertical line marks an event during the test.

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Statistical data in the Info window: Maximum value: largest value during the observation period Minimum value: smallest value during the observation period Difference: difference between the largest and smallest values Mean: arithmetic mean a value: starting value of the regression line b value: slope of the regression line per minute r value: coefficient of determination
Information about the significance of the individual markers can be found in the test manual or in the Vienna Test System's help file. To set the marker function, click the right mouse button, select Settings and then the Marker options tab.

Select the marker signals which are to be displayed.

Signal start: indicates the start of a test or subtest Signal stop: indicates the end of a test or subtest Signal end: if a test battery (consisting of several subtests) is presented, a marker is also set at the end of the battery

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6.2.2 Session evaluation using triggered potentials Click the right mouse button, select Settings and then Triggered potentials.

The clients average reaction before the marker (e.g. before a question was answered).

The clients average reaction after the marker.

Time of the marker. For all trigger points the mean is calculated for each scanning point within a pre-defined range around a trigger point.

Select the marker signal which is to be used as a trigger.

To set the function, click the right mouse button, select Settings and then the Marker options tab.

Time period before the trigger point: sets the length of time before the trigger point Time period after the trigger point: sets the length of time after the trigger point

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7 Notes
The manual provides only a general overview of the software. The complete documentation will be found in the Help texts. You can also use the Info menu option to contact the manufacturer. In addition, the Schuhfried Company regularly runs biofeedback workshops, which provide information about the basis of biofeedback, applications and indications, and also include practical exercises.

We are available for consultation at the following times: Mon. Thurs. 9.00 17.00 Fri. 9.00 14.00 Telephone: +43/(0)2236/42 315-0 Visit our website at:

www.schuhfried.at
E-mail: info@schuhfried.at

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