Enhance Yoga with Biofeedback*

How can you demonstrate that yoga practices are beneficial?

How do you know you are tightening the correct muscles or relaxing the muscle not involved in the movement when practicing asanas?

How can you know that the person is mindful and not sleepy or worrying when meditating?

How do you know the breathing pattern is correct when practicing pranayama?

The obvious answer would be to ask the instructor or check in with the participant; however, it is often very challenging for the teacher or student to know. Many participants think that they are muscularly relaxed while in fact there is ongoing covert muscle tension as measured by electromyography (EMG). Some participants after performing an asana, do not relax their muscles even though they report feeling relaxed. Similarly, some people practice specific pranayama breathing practice with the purpose of restoring the sympathetic/parasympathetic system; however, they may not be doing it correctly. Similarly, when meditating, a person may become sleepy or their attention wanders and is captured by worries, dreams, and concerns instead of being present with the mantra. These problems may be resolved by integrating bio- and neurofeedback with yoga instruction and practice. Biofeedback monitors the physiological signals produced by the body and displays them back to the person as shown in Figure 1.

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Figure 1: Biofeedback is a methodology by which the participant receives ongoing feedback of the physiological changes that are occurring within the body. Reproduced with permission from Peper et al, 2008.

With the appropriate biofeedback equipment, one can easily record muscle tension, temperature, blood flow and pulse from the finger, heart rate, respiration, sweating response, posture alignment, etc.** Neurofeedback records the brainwaves (electroencephalography) and can selectively feedback certain EEG patterns. In most cases participants are unaware of subtle physiological changes that can occur. However, when the physiological signals are displayed so that the person can see or hear the changes in their physiology they learn internal awareness that is associated with these physiological changes and learn mastery and control. Biofeedback and neuro feedback is a tool to make the invisible, visible; the unfelt, felt and the undocumented, documented.

Biofeedback can be used to document that a purported yoga practice actually affects the psychophysiology. For example, in our research with the Japanese Yogi, Mr. Kawakami, who was bestowed the title “Yoga Samrat’ by the Indian Yoga Culture Federation in 1983, we measured his physiological responses while breathing at two breaths a minute as well as when he inserted non-sterilized skewers through his tongue tongue (Arambula  et al, 2001; Peper et al, 2005a; Peper et al, 2005b). The physiological recordings confirmed that his Oxygen saturation stayed normal while breathing two breaths per minute and that he did not trigger any physiological arousal during the skewer piercing. The electroencephalographic recordings showed that there was no response or registration of pain. A useful approach of using biofeedback with yoga instruction is to monitor muscle activity to measure whether the person is performing the movement appropriately. Often the person tightens the wrong muscles or performs with too much effort, or does not relax after performing. An example of recording muscle tension as shown in Figure 2.

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Figure 2: Recording the muscle tension with Biograph Infinity while performing an asana.

In our research it is clear that many people are unaware that they tighten muscles. For example, Mcphetridge et al, (2011) showed that when participants were asked to bend forward slowly to touch their toes and then hang relaxed in a forward fold, most participants reported that they were totally relaxed in their neck. In actuality, they were not relaxed as their neck muscles were still contracting as recorded by electromyography (EMG). After muscle biofeedback training, they all learned to let their neck muscles be totally relaxed in the hanging fold position as shown in Figure 3 & 4.

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Figure 3: Initial assessment of neck SEMG while performing a toe touch. Reproduced from Harvey, E. & Peper, E. (2011).

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Figure 4: Toe touch after feedback training. The neck is now relaxed; however, the form is still not optimum. . Reproduced from Harvey, E. & Peper, E. (2011).

Thus, muscle feedback is a superb tool to integrate with teaching yoga so that participants can perform asanas with least amount of inappropriate tension and also can relax totally after having tightened the muscles. Biofeedback can similarly be used to monitor body posture during meditation. Often participants become sleepy or their attention drifts and gets captured by imagery or worries. When they become sleepy, they usually begin to slouch. This change in body position can be readily be monitored with a posture feedback device. The UpRight,™  (produced by Upright Technologies, Ltd https://www.uprightpose.com/) is a small sensor that is placed on the upper or lower spine and connects with Bluetooth to the cell phone. After calibration of erect and slouched positions, the device gives vibratory feedback each time the participant slouches and reminds the participant to come back to sitting upright as shown in Figure 5.

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Figure 5: UpRigh™ device placed on the upper spine to provide feedback during meditation. Each time person slouches which often occurs when they become sleepy or loose meditative focus, the device provides feedback by vibrating.

Alternatively, the brainwaves patterns (electroencephalography could be monitored with neurofeedback and whenever the person drifts into sleep or becomes excessively aroused by worry, neurofeedback could remind the person to be let go and be centered. Finally, biofeedback can be used with pranayama practice. When a person is breathing approximately six breaths per minute heart rate variability can increase. This means that during inhalation heart rate increases and during exhalation heart rate decreases. When the person breathes so that the heart rate variability increases, it optimizes sympathetic/parasympathetic activity. There are now many wearable biofeedback devices that can accurately monitor heart rate variability and display the changes in heart rate as modulated by breathing.

Conclusion: Biofeedback is a useful strategy to enhance yoga practice as it makes the invisible visible. It allows the teacher and the student to become aware of the dysfunctional patterns that may be occurring beneath awareness.

References

Arambula, P., Peper, E., Kawakami, M., & Gibney, K. H. (2001). The physiological correlates of Kundalini Yoga meditation: a study of a yoga master. Applied psychophysiology and biofeedback26(2), 147-153.

Harvey, E. & Peper, E. (2011). I thought I was relaxed: The use of SEMG biofeedback for training awareness and control. In W. A. Edmonds, & G. Tenenbaum (Eds.), Case studies in applied psychophysiology: Neurofeedback and biofeedback treatments for advances in human performance. West Sussex, UK: Wiley-Blackwell, 144-159.

Mcphetridge, J., Thorne, E., Peper, E., & Harvey, R. (2011) SEMG for training awareness and muscle relaxation during toe touching. Paper presented at the 15th Annual Meeting of the Biofeedback Foundation of Europe. Munich, Germany, February 22-26, 2011.

Peper, E., Kawakami, M., Sata, M., Franklin, Y, Gibney, K. H. & Wilson, V.S. (2005a). Two breaths per minute yogic breathing. In: Kawakami, M. (2005). The Theses of Mitsumasa Kawakami II: The Theory of Yoga-Based Good Health. Tokyo, Japan: Samskara. 483-493. ISBN 4-434-06113-5

Peper, E., Kawakami, M., Sata, M. & Wilson, V.S. (2005b). The physiological correlates of body piercing by a yoga master: Control of pain and bleeding. Subtle Energies & Energy Medicine Journal. 14(3), 223-237.

Peper, E., Tylova, H., Gibney, K.H., Harvey, R., & Combatalade, D. (2008). Biofeedback Mastery-An Experiential Teaching and Self-Training Manual. Wheat Ridge, CO: AAPB. ISBN 978-1-60702-419-4

*Reprinted from: Peper, E. (2017). Enhancing Yoga with Biofeedback. J Yoga & Physio.2(2).*55584. DOI: 10.19080/JYP.2017.02.555584

**Biofeedback and neurofeedback takes skill and training.  For information on certification, see http://www.bcia.org  Two useful websites are:

 

 

 


Are you sure what you saw happened?

We are often 100 percent sure that what we saw or heard really happened even though another person has a different opinion. The more we are captured or focused on a task the more we may miss what has occurred.  Selective attention is the basis of magic tricks by which attention is misdirected so that you do not see what is occurring. This process may affect our daily perceptions and judgements.

Be open to the possibility that your conclusions may be based upon incomplete information or selective attention. For example, when a person has has a car crash and experiences back and neck pain, he is 100 per cent sure that the pain was caused by the car accident.  A more healing attitude is to assume that there could be other factors involved. Possibly, the person had a fight with their partner and was still angry and thinking about it when he was hit. The accident anchored the anger and healing may need to include letting go of the anger. Thus, whenever you are 100 per cent sure of your point of view, be open to other possibilities. Observe the power of selective attention in the following two video clips.


Relax and Relax More*

After raising my shoulders and then relaxing it, I felt relaxed. I was totally surprised that the actual muscle tension recorded with surface electromyographic (SEMG)  still showed tension. Only when I gave myself the second instruction, relax even more, that my SEMG activity decreased.

In our experiences, we (Vietta E. Wilson and Erik Peper, 2014)  have observed that muscle tension often does not decrease completely after a person is instructed to relax. The complete relaxation only occurs after the second instruction, relax more, let go, drop, or feel the heaviness of gravity. The person is totally unaware that after the first relaxation their muscless  have not totally relaxed. Their physiology does not match their perception (Peper et, 2010; Whatmore & Kohli, 1974). The low level of muscle tension appears more prevalent in people who are have a history of muscle stiffness or pain, or in athletes whose coaches report they look ‘tight.’ It is only after the second command, relax and release even more, that the individual notices a change and experiences a deeper relaxation.

The usefulness of giving a second instruction, relax more, after the first instruction, relax, is illustrated below by the surface electromyographic (SEMG) recording from the upper left and right trapezius muscle of a 68 year old male with chronic back pain. While sitting upright without experiencing any pain, he was instructed to lift his shoulders, briefly hold the tension, and then relax (Sella, 1997; Peper et al, 2008). When the SEMG of the trapezius muscles did not decrease to the relaxed state, he was asked to relax more as is shown in Figure 1.

Figure 1 Muscle tension

Figure 1. SEMG recordings of the left and right upper trapezius when the client was asked to lift his shoulders, hold, relax, and relax more. Only after the second instruction did the muscle tension decrease to the relaxed baseline level. Reprinted from Wilson and Peper, 2014.

Although the subject felt that he was relaxed after the first relaxation instruction, he continued to hold a low level of muscle tension. We have observed this same process in hundreds of clients and students while teaching SEMG guided relaxation and progressive muscle relaxation.

For numerous people, even the second commands to relax even more is not sufficient for the SEMG to show muscle relaxation and for them to ‘feel’ or know when they are totally relaxed. These individuals may benefit from SEMG biofeedback to identify and quantify the degree of muscle tension. With this information the person can make the invisible muscle contractions ‘ visible,’ the un-felt tension ‘felt,’ and thus develop awareness and control (Peper et al, 2014).

In summary

  1. Instruct people to relax after tightening and then repeat the instruction to relax even more.
  2. Use surface electromyography to confirm whether the person’s subjective experience of being muscularly relaxed corresponds to the actual physiological SEMG recording.
  3. Use the SEMG biofeedback to train the person to increase awareness and learn relaxation (Peper et al, 2014).
  4. Read the complete article from which this blog was adapted: Wilson, E. & Peper, E. (2014). Clinical Tip: Relax and Relax More. 42(4), 163-164.

References

Peper, E., Booiman, A., Lin, I-M., & Shaffer, F. (2014). Making the Unaware Aware-Surface electromyography to unmask tension and teach awareness. Biofeedback. 42(1), 16-23.

Peper, E., Booiman, A., Tallard, M., & Takebayashi, N. (2010). Surface electromyographic biofeedback to optimize performance in daily life: Improving physical fitness and health at the worksite. Japanese Journal of Biofeedback Research, 37(1), 19-28.

Peper, E., Tylova, H., Gibney, K.H., Harvey, R., & Combatalade, D. (2008). Biofeedback mastery-An experiential teaching and self-training manual. Wheat Ridge, CO: AAPB.

 

*This blogpost is adapted from, Wilson, E. & Peper, E. (2014). Clinical tip: Relax and relax more. Biofeedback. 42(4), 163-164.

 


Making the Unaware Aware*

“You only have to think to lift the hand and the muscles react.”

“I did not realize that muscle tension occurred without visible movement.”

“I was shocked that I was unaware of my muscle activity—The EMG went up before I felt anything.”

“Just anticipating the thought of the lifting of my hand increased the EMG numbers.”

“After training I could feel the muscle tension and it was one third lower than before I started.”

                                                            -Workshop participants after working with SEMG feedback

Many people are totally unaware that they are tightening their muscles and continuously holding slight tension until they experience stiffness or pain. This covert low-level muscle tension can occur in any muscle and has been labeled dysponesis, namely, misplaced and misdirected efforts (from the Greek: dys = bad; ponos = effort, work, or energy) (Whatmore & Kohli, 1974; Harvey & Peper, 2012). This chronic covert tension is a significant contributor to numerous disorders that range from neck, shoulder, and back pain to headaches and exhaustion and can easily be observed in people working at the computer.

While mousing and during data entry, most people are unaware that they are slightly tightening their shoulder muscles. One can often see this low level chronic tension when a person continuously lifts an index finger in anticipation of clicking the mouse or bends the wrist and lifts the fingers away from the keyboard while mousing with the other hand as shown in Figure 1.

Fig 1 hand lift

Figure 1. Lifting the hand without any awareness while mousing with the other hand (from Peper et al, 2014)

People may hold a position for a long time without being aware that they are contracting their muscles. They are focusing on their task performance. They are “captured by the screen” – until discomfort and pain occur. Only after they experience discomfort or pain, do they change position. Factors that contribute to this apparent lack of somatic awareness include:

  • Being captured by the task. People are so focused upon performing a task that they are unaware of their dysfunctional body position, which eventually will cause discomfort.
  • Institutionalized powerlessness. People accept the external environment as unchangeable. They cannot conceive new options and do not attempt to adjust the environment to fit it to themselves.
  • Lack of somatic awareness and training. People are unaware of their own low levels of somatic and muscle tension.

 Being Captured By the Task

People often want to perform a task well and they focus their attention upon correctly performing the task. They forget to check whether their body position is optimized for the task. Only after the body position becomes uncomfortable and interferes with task performance, do they become aware. At this point, the discomfort has often transformed into pain or illness.

This process of immediately focusing on task performance is easily observed when people are assigned to perform a new task. For example, you can ask people who are sitting in chairs arranged by row to form discussion groups to share information with the individuals in front or behind them. Some will physically lift and rotate their chair to be comfortable, while others will rotate their body without awareness that this twisted position increases physical discomfort. As instructors, we often photograph the participants as they are performing their tasks as shown in Figure 2.

Fig 2a sitting on chairs
Figure 2. Workshop participants rotating their bodies or chairs to perform the group exercise (from Peper et al, 2014).

Although there are many strategies to teach participants awareness of covert tension, our recent published article, Making the Unaware Aware-Surface Electromyography to Unmask Tension and Teach Awareness,describes a simple biofeedback approach to teach awareness and control of residual muscle contraction. Almost all the subjects can rapidly learn to increase their recognition of minimal muscle tension as shown in figure 3.

Fig 5 EMG graphFigure 3. Measurement of forearm extensor muscle awareness of minimum muscle tension before and after feedback training (from Peper et al, 2014).

This study showed that participants were initially unaware of covert tension and that they could quickly learn to increase their sensitivity of muscle tension and reduce this tension within a short time period. Surface electromyograpy (SEMG) provides an objective (third person) perspective of what is actually occurring inside the body and is more accurate than a person’s own perception (first person perspective). The SEMG feedback (numbers and graphs) learning experience was a powerful tool to shift participants’ illness beliefs and encourage them to actively participate in their own self-improvement. It demonstrated that: 1) they were unaware of low tension levels, and 2) they could learn to increase their awareness with SEMG feedback.

The participants became aware that covert tension could contribute to their discomfort and would inhibit regeneration. In some cases, they observed that merely anticipating the task caused an increase in muscle tension. Finally, they realized that if they could be aware during the day of the covert tension, they could identify the situation that triggered the response and also lower the muscle tension.

For detailed methodology and clinical application, see the published article, Peper,E., Booiman, A., Lin, I-M., & Shaffer, F. (2014). Making the Unaware Aware-Surface Electromyography to Unmask Tension and Teach Awareness. Biofeedback, 42(1), 16-23.

References:

Harvey, E. & Peper, E. (2012). I thought I was relaxed: The use of SEMG biofeedback for training awareness and control. In W. A. Edmonds, & G. Tenenbaum (Eds.),Case studiesin applied psychophysiology: Neurofeedback and biofeedback treatments foradvances inhuman performance. West Sussex, UK: Wiley-Blackwell, 144-159.

Whatmore, G. B., & Kohli, D. R. (1974). The Physiopathology and Treatment of Functional Disorders: Including Anxiety States and Depression and the Role of Biofeedback Training. Grune & Stratton.

*Adapted from: Peper,E., Booiman, A., Lin, I-M., & Shaffer, F. (2014).Making the Unaware Aware-Surface Electromyography to Unmask Tension and Teach Awareness. Biofeedback.42(1), 16-23.