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The Future of Biofeedback: New Wearables and Apps

The Future of Biofeedback: New Wearables and Apps for Biofeedback and Neurofeedback Clinical Practice Applications Dr. George Fuller von Bozzay Biofeedback Inst. of San Francisco There is a health technology revolution. Now for the first time the public is becoming aware of physiologic measurement with the use of wearables and apps in their every day lives. Many of these devices are appropriate for bio/neurofeedback training. With the development of new technology, smart phones, tablets and smart watches the public is getting used to carrying devices with extreme capability. Now the trend towards being able to wear these devices and to monitor activity is hitting critical mass. With the explosive development of activity trackers, sleep trackers, even monitoring rings, as well as flexible screens and electrodes, the public is now becoming aware of physiological monitoring and its usefulness. Biofeedback is on the cusp of a revolution In acceptance, understanding, and use as these trends come together. There are already apps for biofeedback, for monitoring heart rate, heart rate variability , GSR/Electrodermal response, temperature and blood pressure. In the past two years we saw the development of many different physiologic monitoring devices embedded in wearables of various kinds including smart watches by Apple, Samsung, and other major companies. This article reviews the currently available devices, apps and wearables as well as discusses their positive and negative features and how they can be used by the biofeedback practitioner both in-office and for home practice. We have a unique opportunity at this time to move the field of biofeedback from it’s present small, insignificant, and unknown state, to being on the forefront of healthcare and massive public use. With the development and increasing popularity of wearables and apps, biofeedback can finally capture the public’s imagination and be used as intended, for the learning of self regulation skills and internal health care. It is increasingly important to bring this knowledge to the world, and this is the time and way to do it. Young millennials are interested in tech and devices, and also in their health and consciousness. While they are not now aware of biofeedback, this app and wearable development can be the bridge to bringing them, along with the rest of the public, into this philosophy and application of being an active participant in one’s own health, rather than passive recipient of medical services and medication. Best current apps: (check Biomedical instruments 800-521-4640 or Amazon for their current pricing.) GSR – e-sense by Mindfield ($99 biomonitoring applications) has a graph of electrodermal response, data, as well as a customizable video clip feedback screen. HRV/respiration- Inner Balance , (HeartMath $129)(Wireless Bluetooth sensor version $159),This successor to the Emwave, this device provides good graphics for HIV/respiration training providing both a professional screen and training screens. Biostrap - band monitors HR, HRV, SPO2, Resp, activity, and sleep ($199.) While it looks like a typical activity tracker,It is anything but. It provides downloadable graphs and data points for these physiologic measures on a daily basis. Respiration and activity tracking – Spire, ($110 Spire) Stone is worn on belt throughout the day and buzzes if tense. Now the new permanently worn, washable, Health Tag -adheres to waistband requires no charging, includes sleep tracking , HR and HRV, and true respiration training screen. EMG – Cricket by Somaxis $250 multiple Wireless Bluetooth sensors can be placed anywhere on the body. EEG – limited artifact detection, But can be used for general brainwave training. Emotiv-Insight headset mobile ($299) -five sensors, Motion sensor detects head movement. Epoc+ headset Mobile ($799) 14 channel more professional grade. Neurosky -Mind wave mobile ($100) Basic brainwave training with many apps. Muse($149) primarily for meditation with good sound and visual feedback and training graphs. Muse 2 ($249) updated and includes heart rate and respiration and posture feedback. Other- Watches – Apple Watch series 4 ($400 +) able to do EKG/HR, Has very good breathing pacer, notification of various activity modes. And is poised to tackling other healthcare challenges. Rings- Constant activity HR and sleep monitor in a ring – MOTIV (199.), OURA (299) – also measures temperature and BVP. Other useful instruments: Pulse oximeter – Oxygen saturationMeasure from fingertip (Santamedical , Amazon, $22)(Also faceLake FL $14) (there are usable versions available for $9). Temperature – noncontact infrared thermometer (Amazon $18) Posture- Lumo Lift ($99 +) sticks on and provides haptic feedback.

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