Biofeedback trainer «Breathing»

 

User's Manual

Part 1. Basic information

 

§1. Introduction

  Biofeedback trainer "Breathing" is a new version of the highly successful RSA training biofeedback system and intended to:

  • Restore and strengthen one's health by forming the correct diaphragmatic relaxation type of breathing (breathing with Smetankin method). This type of breathing is one of the most effective modern free-medication ways of correcting organism function disorders, caused by stress or illness.
  • Define the level of inner resources of the organism (health level diagnostics) from the value of Respiratory Sinus Arrhythmia (RSA) and the extent to which the work of the respiratory system and the heart is harmonized;

  Important!

  For your better understanding of breathing with Smetankin method we suggest you to look through the literature devoted to this person matter.

  Being an instrument of getting the reliable information about the cardio and the respiratory system, Biofeedback trainer "Breathing" does not adversely affect the organism, and does not interfere with any physiological processes.

  It also gives you the unique chance to correct your own body functions so as to get rid of causes and manifestations of many disorders of the nervous, respiratory, and cardio-vascular systems.

  Special terms:

  Biofeedback (BFB) is transforming and presenting the information on person's organs and systems, using the technical resources. A person begins to see, hear, and understand the processes inside his organism. A person is presented with a possibility to correct them by connecting the powerful conscious, memory and training mechanisms to the process of correcting. A person becomes able to control the organism and increase the defensive powers level.

  Respiratory Sinus Arrhythmia (RSA) is a difference between the heart rate (HR) values during inhalation and exhalation. During inhalation the heart beats faster and the heart rate increases. During exhalation HR decreases accordingly.

  RSA can appear with anybody. It is a sensitive indicator of quality of breathing, level of defensive powers, and adaptive abilities of organism. The higher the RSA value (maximum individual RSA), the better illness protection appears within organism. That index is involved as a training object in Biofeedback trainer "Breathing".

  RSA is an individual index changing with the person's age. Children have the largest RSA value (40-50 beats/min.). In age of 25-40 years old it is 20-25 beats/min. And in age of 65-70 years old it is 1-3 beats/min.

  RSA value depends not only on the person's age but also on his health condition. RSA value decreases if a person feels bad or psycho-emotionally over-tensed.

  RSA is a functional index one can train easily. Having mastered diaphragmatic relaxation breathing a person is able to easily produce the maximum individual RSA increasing his organism functional possibilities of his own will, and where an elderly person is concerned, to prolong his active longevity.

  Diaphragmatic relaxation type of breathing (abdominal breathing) is the most natural and optimal type of breathing. The diaphragm and lower lungs compartments perform it. After having mastered this type of breathing, a person can get the ability to correct the functional condition of organism in disorders and diseases by himself, the person can also use this type of breathing for general health strengthening.

 

§2. Complete set

The trainer includes the following components:
  1. Main cardiosignalizer CS-04 unit.
  2. One set of EKG sensors.
  3. One rubber strap for fixing sensors.
  4. Two rechargeable batteries.
  5. One battery charger.
  6. One external power supply unit.
  7. One set of headphones.
  8. CDROM with software "Breathing 1.1" installation.
  9. Operations and Applications Manual.
  10. Packing.

  The Trainer can be used as a stand-alone device (Cardiosignalizer CS-04) or with a computer.

  Using a soft ware one can get the following advantages:

  • The total number of sessions necessary for mastering diaphragmatic breathing reduces.
  • Data of virtually limitless amount of users can be stored. One can follow the function changes from session to session.
  • Sessions converse into fascinating game.
  • One can easily train his children and relatives in diaphragmatic breathing.

 

§3. Indications and contra-indications

  1. Indications. Biofeedback trainer "Breathing" is desirable for:

  1.1. Children and adults, suffering from:

  • Bronchial asthma, allergic diseases of the respiratory system, chronic bronchitis and other diseases of the respiratory system.
  • Frequent and prolong acute respiratory virus infectious diseases.
  • Decrease of the defensive powers of organism.
  • Chronic tiredness, sleep disorders, low workability and other disorders of the nervous system.
  • Manifestation of psycho-emotional over-tension.
  • Manifestation of autonomic vascular dysfunction.
  • Hypertension.
  • Headaches.
  • Speech disorders, connected with a high level of anxiety, or unstable emotional condition.
  • Behavior disorders (hyperactive kid with lower ability of assiduity, attention concentration, or not able to social contacts).

  1.2. Healthy people who are under the prolong effect of stressful social factors, fear, and high anxiety (pre-pension age, fear of possibility to fall seriously ill or of being dismissed from office, failure in career, family discords) for heightening their capacity for work, decreasing high fatigue as well as for reducing the risk of disorders caused by chronic stress.

  1.3. Elderly people for enhancing their vitality, extension of active longevity, correction of disorders of the nervous system, the heart, and the respiratory system.

  2. Contra-indications.

  2.1. There are no absolute contra-indications.

  2.2. There are relative contra-indications:

  • Age less than 4 years old.
  • Gross infringements of volitional sphere, intellect (in such a case, as well as with children younger than 4 years old, it is difficult to use biofeedback as the person cannot understand the simplest directions, which are necessary for ÓÅ performing the exercises).
  • Accompanying somatic disorders in acute stage (after coping with the acute stage biofeedback sessions are not only possible but also advised as they shorten the rehabilitation period).
  • Heightened convulsive readiness of the brain.
  • Exacerbation of any chronic illness.

 

§4. Guidelines on conducting training sessions with the help of the biofeedback trainer «Breathing»

  1. A user can master the do's and dont's for the work on the trainer.

  2. The objective of the sessions is:

  2.1. To acquire diaphragmatic relaxation breathing and to learn the skill of producing the maximal RSA value.

  2.3. To actively apply the acquired habit of breathing in everyday life (without biofeedback devices) for:

  • general strengthening the health;
  • decreasing psycho-emotional tension caused by any stress;
  • correction of organism functions disordered by illness;
  • prophylaxis of different diseases of the respiratory, cardiovascular, and nervous systems.

  2.4. To control the level of your health and the health of your kindred.

  3. We advice to keep to the following order while acquiring the habit of diaphragmatic relaxation breathing:

  3.1. To learn abdominal breathing.

  3.2. To learn working with the biofeedback trainer "Breathing".

  3.3. To carry out supporting biofeedback sessions once every two-three months.

  3. Suggested duration of biofeedback training course is no less than 10-12 sessions. The biofeedback course can be prolonged at will for 5-8 sessions.

 

§5. The rules of mastering diaphragmatic relaxation breathing (abdominal breathing)

  Before training do please remember seven important rules, which will help you find your health reserves.

  • Rule 1. There are no people who can not master Smetankin method!
  • Rule 2. It is never late (or early) to begin if the age is more than 4-5 years old.
  • Rule 3. Follow the rule: "move from simple to complex". Do not seek high result in a moment.
  • Rule 4. Exhalation is the most important! On acquiring the correct exhalation you will by all means achieve a desirable result.
  • Rule 5. Your sessions should be regular. We advise to carry out two sessions (in the morning and in the evening) no less than three times a week. Decline to train when you are ill.
  • Rule 6. Do not endeavour. The less effort the sooner you acquire diaphragmatic relaxation breathing.
  • Rule 7. The sessions should be conducted in a comfortable situation. Nothing should worry or annoy you or distract you from the session.

  Note

  The mechanism for the diaphragmatic relaxation breathing was laid into us by nature. It is the oldest type of breathing, which is inherent in all warm-blooded animals and was lost by humans in evolution.

  The basic muscle, which participates in this breathing, is the diaphragm. It separates the abdominal and thoracic cavities. In inhalation the diaphragm contracts enabling the lungs to maximum open flats and presses the abdominal organs to the abdominal wall causing it to bulge out and become rounded. In exhalation the diaphragm relaxes pressing the lungs from below and the abdominal wall is drawn in. During breathing the upper thorax does not move. It shows up as breathing with the abdomen.

 

§6. The general principles of diaphragmatic relaxation breathing

  It is advised to master the general principles of diaphragmatic relaxation breathing with the trainer removed.

  The first stage objective is to learn abdominal breathing.

  1. Find a comfortable position in an armchair or a sofa. Nothing should cause any discomfort inconvenience to you. It is advisable that all tight clothing (belts, bras) is loosened, a seat is soft, with a back (you should not experience any extra tension of muscles of you back and shoulders). External irritants such as radio receiver, TV set, etc. should be switched off. These are the simplest but necessary conditions for the beginning of the training.
  2. On closing your eyes mentally look into yourself taking notice of nothing, and relax your face and shoulders. Feel the skin on your forehead smoothed down, your shoulders gone down, your respiration regular, and your thoughts stopped getting confused and flowed smoothly. Sit in such a position for one or two minutes. Calm down.
  3. Put one hand on your abdomen above the navel and the other on your chest. When your hand on the abdomen moving and your hand on the chest immovable, you're breathing correctly.
  4. Inhale through your nose without efforts. By no means force your natural movement. Your abdomen should become rounded as if the air enters not only the lungs but also the abdomen filling the latter as a balloon.
  5. Pass to the exhalation without a pause. Exhale through the mouth slightly opened. There must be some resistance to the exhalation. The abdomen is slowly drawn in helping the lungs become free of the exhaled air. Do not force the abdominal wall movement.
  6. It should move smoothly and natural. While exhaling imagine your exhalation as a light morning wind filling the sails of a yacht.
  7. Exhale from 2 to 4 times longer than inhale. This is important. Pay particular attention to it. The proper exhalation is a considerable progress in mastering diaphragmatic breathing.
  8. After the exhalation the inhalation starts without delay and pause. The breathing cycle repeated.
  9. After exercising for 1 or 2 minutes make a break for two or three minutes. Then repeat the exercise. Do three or four cycles "work-rest". Then finish the session.

  Important!

  If your comfortable condition was not upset during your exercises, if you did not gasp for breath, if your abdomen expanded during inhalation and was drawn in during exhalation, while your chest not moving you conducted your first session quite correctly. We congratulate you on the first success. You have mastered the general principles of diaphragmatic relaxation breathing!

  Diaphragmatic type of breathing is known for a long time (It was used by Indian yogis, in the Chinese exercises tzi-gun, etc.). But for rendering healthy it is necessary to learn to synchronize the respiratory and cardiovascular systems that took years of tenacious training. So until the recent time but few people have been masters of the secret of such a respiration.

  The basis for the Trainer operation is biofeedback. So any person can master this type of breathing for three-five sessions. And in 10-15 sessions your health will improve.

  Note

After the examination of the operation of the Trainer and its part the device "Cardiosignalizer".

 

§7. Biofeedback device «Cardiosignalizer»

  1. The portable Biofeedback device "Cardiosignalizer" (further cardiosignalizer) is a part of the Trainer. With the help of this device they get a reliable information about the work of the respiratory and cardiovascular systems. Cardiosignalizer does not adversely affect the organism, and does not interfere with any physiological processes. At the same time it enables one to get rid of the causes and manifestations of many disorders of the respiratory, cardiovascular and nervous systems.

  Cardiosignalizer registers the physiological index respiratory sinus arrhythmia (RSA) and trains to control it.

  2. Training with the help of cardiosignalizer is directed to the developing of a steady habit to breathe diaphragmatically, effortlessly, and calmly with slow exhalation. Training makes it possible to realize the maximum synchronization between the phases of respiratory cycle and heart rate oscillations. It is the synchronization, or harmony, of the work of the respiratory system and the heart, that one has to seek to during the sessions. The extent to which this harmony is realized is an index of the level of activization of the health inner reserves.

a. Location of plugs and controls on the panels of the cardiosignalizer.

  1. — the plug for connecting EKG sensor to the unit;
  2. — the plug for connecting the external power adapter 9 V;
  3. — the plug for attaching to COM2 plug of a computer with the help of the null-modem cable (delivered with Biofeedback stimulator "Breathing");
  4. — the switch ON/OFF combined with the volume control - the dial "Volume ON/OFF";
  5. — the cover of the battery compartment;
  6. — the plug for connecting headphones;

b. Controls and inscriptions on the digital display LCD.

  1. — current heart rate reading, beats/min.;
  2. — time passing from the beginning of the training session;
  3. — upper heart rate threshold, beats/min.;
  4. — lower heart rate threshold, beats/min.;
  5. — button switching on/off timer;
  6. — button switching on/off illumination of the LCD;
  7. — button for increasing the upper threshold;
  8. — button for decreasing the upper threshold;
  9. — button for increasing the lower threshold;
  10. — button for decreasing the lower threshold;
  11. — button for switching on/off the light bar.

 

§8. Preparation of the device for operating

  1. Before working with the device make a close study Manual "Cardiosignalizer CS-04" and a given Manual. Take the device out of the case. Wipe all the parts of it with a moist cloth not allowing liquid to get inside it. Then absorb all the liquid with a dry cloth.

  2. Make a close study of purpose and location of plugs and controls in ; location of information on the digital display and controls on the front panel of the unit in.

  3. If you use the device without a computer:

     3.1. To work with the internal power supply (rechargeable battery):

  • charge a rechargeable battery with the help of the battery charger;
  • open the cover 5 of the battery compartment;
  • insert the battery making sure to orient with correct polarity;
  • close the cover of the battery compartment.

     3.2. To work with the external power supply:

  • connect the external power supply "Adapter 9 V" to the plug 2 on the rear panel;
  • connect "Adapter 9 V" to the mains supply through a filter.

     3.3 Connect "input" of EKG sensor with the unit through the socket 1 on the left side panel of the unit.

  4. If you use PC together with the cardiosignalizer:

     4.1. Connect "input" of EKG sensor with the unit through the socket 1 on the left side panel of the unit.

     4.2. Use any power supply.

     4.3. Connect cardiosignalizer (through the socket 3 ) with the help of the null-modem cable to PC through the 9-pin plug with mark 2. Note: If you use PC the Light bar can be switched off that does not adversely affect the Trainer operating.

 

§9. Carrying out training

  1. With the help of the sensors attached to the person's chest the device registers electrical activity of the heart (electrocardiogram - EKG) and calculates the current heart rate (HR) (it is shown on the digital display).

  2. The current HR is transformed into signals of the visual and auditory feedback. The visual feedback a light bar indicator consisting of 12 LEDs. If cardiosignalizer is used with PC the visual feedback is presented on the monitor as a moving picture.

  3. The current heart rate is also compared with the upper and lower thresholds preset before the work individually for each person. The thresholds are set with the help of the respective buttons on the front panel of the device or with the help of the soft ware "Breathing".

  4. If you use the device without PC while the current HR increases during inhalation the light spot is moving up along the light bar and while the HR decreases during exhalation the light spot is moving down along the light bar. At the same time as the light spot moves along the light bar the hitch of the auditory feedback signal changes. There is a visual and auditory signaling of the current heart rate going beyond the thresholds: the first and the last LEDs flash with the frequency of the current HR and the sound becomes broken.

  5. If you use the cardiosignalizer together with PC all the information about heart work and respiration is represented in the soft ware "Breathing" in accessible for understanding form (see part 2).

  6. At the beginning of the Biofeedback training it is necessary to attach the EKG sensors to the person's body on the right and the left of the middle-clavicular line on the level of the forth or fifth rib with the help of the rubber strap. Adjust the tension of the rubber strap so that on the one hand, the sensors were not pressed into the skin, and on the other, the good contact sufficient for reliable registration of EKG signals was ensured. Before and after every session treat the sensors with 70°-spirit solution.

  7. Examine if the strap badly tightens the person's chest. It should not cause inconvenience in breathing.

  8. Open the cover-panel of the cardiosignalizer up to the stop.

  9. Switch on the device turning the control "Volume ON/OFF" in the direction of "ON" until you hear a click. On the LCD there will show up the words "JSCo Biosvyaz" (for 1-2 s) and then the set values:

  • HR___________________00;
  • Upper threshold________90;
  • Lower threshold________ 60;
  • Session time___________00.

  It means that the device is in running order. In a few seconds the HR value will correspond with the current heart rate.

 10. If the HR values are unreal (for example 1, 5, 250, 300) make sure that:

  • the EKG sensors are attached to the body correctly;
  • the EKG sensors are connected with the device;
  • the battery is charged. If the figures on the LCD are flashing with the frequency about once a second it is necessary to switch off the device and charge the battery or connect the device to the external power supply.

 11.The device is registering the current HR. It is shown on the LCD and conversed into signals of vision feedback (the light spot moving along the light bar ) and auditory feedback (the pitch of sound changing).

 12. If you use PC the current HR is presented in the soft ware "Breathing".

 13. Adjust the volume of the audio signal with the help of the control "Volume ON/OFF". If the person prefers working with the earphones connect them to the plug 6 . In this case the external loud speaker is switched off automatically.

 

§10. Setting the thresholds

  1. It is necessary to set the HR thresholds.

  2. The person can close his eyes and breathe calmly in his normal rate. The light bar can be switched off. For 5-10 respiratory cycles observe the HR values on the LCD . For example there are the following values: 80, 65, 82, 63, 81, 60, 85, 61, 83, 62.The average of them is about 72.

  3. Define the values of the thresholds.

   For a middle-aged person:

  • With the help of the buttons 7 and 8 set the upper threshold equal to 72+5=77.
  • With the help of the buttons 9 and 10 set the lower threshold equal to 72-5=67.

Now the person can control his heart rate in the limits from 67 to 77 beats/min. In setting the thresholds keep in mind the person's age. For example, for a child of 10 years old you can set the following thresholds: the upper one is 72+10=82 and the lower one is 72-10=62 and for the elderly they will be 72+2=72 and 72-2=70.

  4. Set the thresholds. If you do not use a PC the thresholds are set with the help of buttons 7 and 8 (the upper threshold) and 9 and 10 (the lower threshold).

  If you use a PC the thresholds are set during the first work period of the soft ware "Breathing" (see part 2).

  Note

  If you use the cardiosignalizer without PC go to the part 3.

 

 

Part 2. Operation of trainer «Breathing» with PC

 

§1. Minimal system requirements for working with Software «Breathing 1.1»

  • Processor — Pentium 150
  • RAM 16 Mb (desirable 32Mb)
  • 16-bit sound card
  • Video — ATI Match Video boost and higher with 1Mb memory and higher
  • CD-ROM Drive

 

§2. Software «Breathing 1.1» installation

  Insert Installation CD in CD-Rom. Follow the instructions in the file readme.txt.

 

§3. Launching the software «Breathing 1.1». Main menu

  1. Connect the the cardiosignalizer to the PC (see part 1, §8, point 4,. )

  2. After installation of the software "Breathing 1.1" (see part 2, §2) click "Start"; choose "Programs", then "Breathing 1.1". After launching the program the inscription "Breathing 1.1" and the main menu appear on the screen .

     3. Main menu consists of the following items:

  3.1. "Create new card": to create the card for a new person. Dialog window appears with the edit box at the top and list of existing persons at the bottom . This name should not coincide with the available names and must not contain symbols prohibited for filenames: *. ? / | \ . To confirm creating the person's card and start working with it, click "OK". To cancel the forming process and return to the main menu, click "Cancel".

  3.2. "Open existing card": to open an available person's card. Dialog box appears with the list of the available persons . Click on the name of the person and click "OK". To return to the main menu press "Cancel".

  3.3. "Delete card": to remove all the information on the person from the database. Dialog box appears with the list of the available persons . Click on the person's name and click "Delete card" button. To return to main menu click "Cancel" button. After confirmation person card is deleted.

  Important!

  This cannot be undone. So use this only when you are sure you will not need the information on that card.

  3.4. "Exit": to exit the program.

 

§4. Working with a card

  After selecting a card through menu "Create new card" or "Open existing card" you can view and edit any text information about the person.

  1. "Personal data": Viewing and editing the person's data or any text information you consider important to put in. 

  After selecting this item a window with memo box appears . To print that information you have to click "Print". To cancel all data click "Undo changes". To save all changes and to go back to the "Working with Card" menu, click "Save changes and exit".

  2. "New session": begin scheduling new treatment session. Detailed information can be found in "Select a program version from the list"§5.

  3. "Sessions results": view and statistically process session data (see part 2, §11 "Viewing and evaluation of session results").

  4. "Close": to close the person's card and to return to the main menu of "Breathing 1.1".

 

§5. Selecting a program version from the list

  1. After selecting "New session" in "Working with the person" menu dialog box appears with the list of the available program versions to begin scheduling with .

  2. Select the desired version and click ''Start session" button.

  Special terms

  Program version - is a set of controls provided by "Breathing 1.1" allowing to choose the types and duration of work/rest periods and adjust their settings to match your requirements.

  Work period - a period preset by the program when a person is acquiring a habit of diaphragmatic relaxation breathing, controlling the current heart rate (with the help of the feedback signals); developing a skill to maximum reduce the heart rate during exhalation, to restore harmony of breathing and cardiac system, and to reach maximum individual RSA.

  Rest period - a period preset for shifting the person's attention from achieving the tasks, given in the work period to reviewing a set of different slides and listening to relaxing music. The feedback signals are not presented.

  In a rest period the computer continues recording current heart rate. It allows receiving a comparative picture of changes of heart rate values, breath frequency and RSA when a feedback presents and when it is absent. Comparing outcomes of work and rest periods allows to see how well the person acquire the exact type of breathing, and how quick he manages to restore harmony of breathing and cardiac functions.

 

§6. Description of program versions

  1. All program versions begin with a minute of background indices recording.

  In a background recording time a screen shows a set of subject slides (subject: "Water" and "Roses") with 10-second period.

  In the lower part of the screen control buttons are arranged from left to right: "stop", "the next", "end" "oscillograph". In a right lower corner there is a window "current time of a session".

  In a background recording time the quiet pleasant tune sounds to let the person get accustomed to the BFB session.

  2.The display buttons give possibility to discontinue the current period of the version:

     2.1. "Stop" button stops the current period of a version. With the mouse clicking this button the pause mode occurs. On the button there shows a sign "Continue".

  When this button pushed twice the current period will continue. This option allows interrupting the current period of the version for unlimited period and getting back to it from the moment you have stopped the current period of the version.

     2.2. "Next". Clicking this button interrupts the current period of the version. By clicking this button you immediately interrupt current work period or rest period and pass to the period next to it. The sequence of the periods in versions is described in Part 2, §7.

  Note

  When clicking "New session" and selecting the program version by the cursor you can get acquainted with the scheme of this version.

     2.3. "End" button completely stops the session. Clicking this button stops the work of the program version and shows a window of "sessions results".

     2.4. "Oscillograph" button stops a minute of a background record and enables to see electrocardiograph signal .This curve can not be shown to a doctor for diagnostic of a functional heart condition.

  By clicking the button the background record minute is suspended, and overhead of screen the black window will be opened, which will show the curve of a heart rate signal from left to right.

  This mode allows controlling a regularity of the person's heart rate registration by the trainer. Having convinced, that the signal presents, (it looks like an electrocardiograph curve), in 2 - 3 seconds by double clicking the "oscillograph" button you can shut this window. The background record minute will continue.

  Important!

  Do not hold an "oscillograph" window open long, as in this period the record of background parameters is not conducted!

  2.5. "Current time of the session" window is a digital readout "0:00:00" of the version total duration.

  Important!

  After clicking the "Stop" button or "oscillograph" button the time counting is suspended.

  The repeated click of these buttons will continue the current period and readout of the total time of the version.

  3. After background parameters are recorded the program turns automatically into the work period.

  4. The program automatically changes from a work period to a rest period.

  5. The end of a program version automatically opens a "Session results" window (see part 2, §11).

  Special terms:

  Minute of background recording - time, preset by the program to control the heart rate signals in the PC, to record background parameters and the person's psycho-emotional condition for carrying out a BFB session.

  Current program version period - the work or rest period, which is directly displayed on the monitor.

  Background parameters - indices of minimum, maximum and mean heart rate value, breath frequency and RSA, which will be registered during a minute of background recording.

  Background parameters are automatically put on the chart and in the session total table, which are presented by the program after closing-up a version period. These parameters give you a capability to estimate the success of conducted BFB session.

 

§7. Frame of program versions

  1.To represent the frame of program versions the basic information is shown in the table:

  2. Frame of program versions should be read from left to right, starting with the minute of a background recording. It is indicated in the table by characters "b.r."

  Example of reading of the table:

  We have selected a version No2 from the table and we read it:

    1. Beginning of a version - background recording minute. A subject line of slides "Roses", musical scene "V-Love Theme..." Duration - one minute.
    2. Further we look at a right part of the table, goes the work period called "Column". There is no music. Its duration - two minutes.
    3. It is replaced by the rest period (we look at the left-hand part of the table) with a subject line of slides "Peterhoff" and musical scene "V - Come To Me". Its duration is one minute.
    4. Further there comes the second work period with a title of a scene "Butterfly". It lasts two minutes. It is substantiated with musical composition " V-Main Theme..."
    5. Then there goes rest period with a set of slides "Cities". The scene is accompanied by musical composition V-Dream In An... Duration of the period - one minute.
    6. The third period of work with a subject line "Window" and set of slides "Plants" and music "V-La Petite Fille..." Duration - three minutes.
    7. The program version ends up by rest period with a subject line of slides called "Sunsets".

  3. The program versions are parted into cycles "work - rest". In program versions NoNo 1-3 and 7-9 three cycles "work - rest", in program versions NoNo 4-6 and 10-12 - four cycles are stipulated.

  4. The duration of work period oscillates depending on program version from 2 to 4 minutes.

  5. The duration of rest periods makes 1- 2 minutes.

  6. Total duration of sessions depending on set-up of program versions varies from 10 to 24 minutes.

  Note:

  Changing program versions by the user of software is not valid.

 

§8. Periods of work

  1. Bar

  Bar of variable height is a basic visual shape of biofeedback to be used at the first stage of learning the diaphragmatic breathing . When the person inhales the bar goes up with the heart rate. During the exhalation it goes down. Zero height of the bar corresponds to the lower threshold for the heart rate . The maximum height of the bar (equal to the frame) corresponds to the upper threshold . On the left there is a fraction in the denominator of which there is the total quantity of breaths and in the numerator there is the quantity of correct breaths when there was achieved the lower threshold.

  Visual biofeedback can be accompanied by the auditory biofeedback signal: midi tone of variable pitch. The pitch changes from low to high according to the heart rate value. On achieving the lower threshold the sound becomes broken.

  The volume control of the loudspeaker is used for on/off switching the auditory feedback.

  2. Fence or vertical painting (opening) the stripes.

  This visual shape of biofeedback is used to bring some motivation to the treatment process. During the session the person paints the fence , reveals a landscape behind the window , or paints the butterfly using diaphragmatic breathing. If the person breathes correctly (on the exhalation the lower heart rate threshold is reached), the situation will go on (e.g. after the exhalation the next section of the landscape is revealed). If a mistake is made, the computer notifies the person about it and asks to repeat the exercise (e.g. to reveal the same section of the landscape once more).

  There are used four versions of subject sets of slides:

  • Landscape;
  • Sea;
  • Ships;
  • Plants.

  3. Animation

  This is a game situation designed for children. An animated character (e.g. bee or Winnie-the-Pooh) is moving from one location to another and back to the first one in accordance with the person's breathing. At the bottom of the screen a success line is located. Every correct breathing cycle one point is added to it.

 

  4. Biofeedback control of heart rate

  This control is the basic type of biofeedback control for training diaphragmatic relaxation breathing, adjusting heart rate thresholds and displaying information on the current functional condition of the person. In the left part of the panel brown heart rate bars are located. Threshold controls are in the center of the panel. Click "Up" and "Down" arrows to adjust the current settings (see part 1, §10). Heart rate bars (pulsogram) are automatically scaled with the adjustment of the thresholds. In the right part of the panel statistic parameters are presented: current heart rate, averaged heart rate, averaged RSA value, and duration of the last breathing cycle.

  Special terms:

  Visual feedback is an object on the screen movement of which corresponds to the heart rate variations with inhalation and exhalation.

  Auditory feedback is a midi tone the pitch of which corresponds to the heart rate variations with inhalation and exhalation.

  Pulsogram is a graphical display of heart rate values.

  Upper and lower thresholds are presetting limits for heart rate changes from the maximum during an inhalation to the minimum during an exhalation.

 

§9. Periods of rest

  1. In a rest-period you see slides on the screen, which change every ten seconds and are accompanied by calm music tune. There are 8 sets of slides:

  • Landscape,
  • Sunsets,
  • Sky,
  • Winter,
  • Animals,
  • Fishes,
  • Cities,
  • Peterhoff.

  There are four or five sets of slides in every version. You cannot change these sets on your own.

 

§10. Carrying out a session and estimation of the results

  1. Connect the cardiosignalizer with the PC (part 1, §8, point 4), adjust the sensors with the help of the belt (part 1, §9, points 6-7). Switch on the cardiosignalizer (part 1, §9, points 9-13) and PC, launch the soft ware "Breathing 1.1".

  Note:

   If the inscription "CS-04 is not found. Check the connection" emerges or if a window at the top of the screen is not black but gray when the button "oscillograph" is pressed it means there is no reliable connection of the device and PC .

  Make sure that the sensors are reliably and correctly attached to the body, that they reliably connected to the device, that the device is correctly connected to the PC. Exit the program and once again enter it. Launch a program version and make sure that there is heart rate signal.

  If the fault has not been eliminated you are advised to take the help of the producer.

  2. Click " Create new card".

  2.1. Fill in the card your name and click "OK". There will be opened the panel "Subject". Click "Personal data".

  2.2. Enter the information about yourself you consider needed and click "Save changes and exit". You will return to the panel "Subject".

  Note:

  All the next sessions begin with the main menu clicking "Open existing card". Then select the card you need on the panel "Subject". Then follow point 3.1.

  3. Click "New session" and the panel "Select a program version".

     3.1. Select a version and click "Start session". You will see a slide on the screen and hear a musical melody.

     3.2. Click "Oscillograph" and for a few seconds watch the heart rate signal goes into the trainer. Close the panel "Oscillograph" and go on with a control minute, which will automatically go over to a work period and then to a rest period and so on to the completion of the session.

  With completion of the session the panel with the session results will appear on the screen. How to work with it you can see in Part 2, §11.

  3.3. Carry out the session adjusting the upper and lower thresholds when needed (Part 1, §10).

  3.4. Complete the session clicking "Close". The panel "Subject" will open.

  3.5. Click "Main menu" and enter the main menu.

  3.6. Click "Exit". Your work with the software "Breathing 1.1" is finished.

 

§11. Viewing and estimating the results of the session

  1.The panel "Viewing the results" consists in a plot of heart rate versus time, a summary table of principal results of the session and a set of control buttons.

  2. A plot of heart rate versus time.

  On the vertical axis the heart rate values in beats/min. are plotted, and on the abscissa current time of the session in minutes and seconds is laid off. The red curve relates to periods of work and black one - to periods of rest.

  3. A summary table of principal results of the session.

  The table is located at the bottom of the screen .

  It contains the following indices:

  • Average heart rate (HR arg).
  • Maximal heart rate (HR max).
  • Minimal heart rate (HR min).
  • RSA.
  • Breath rate (Br. freq.)

  The table is divided into vertical columns each of them corresponds to 1 minute of the session. Periods of work and rest are separated with their color.

  4. Control buttons for editing the previous sessions and saving the current session.

  These buttons are located at the top of the screen .

With their help you can view the session results, edit, print and save/delete them.

  • "Open session" - a button for calling the menu for selecting a previous session of this person. Select the wanted session by the date of its conducting and click "Select". On finishing click "Close".
  • "Save exclusions" - a button for saving the session results after exclusion of artifacts.
  • "Print" - a button for printing the results of a session.
  • "Delete session" - a button for deleting this session.
  • "Close" - a button for closing this panel.

  5. Control buttons for editing the current session.

  These buttons are located on the left and below pulsogram.

  On the left there are located the buttons for scaling the vertical axis:

  • "Upper limit" - a button for changing the scale of the vertical axis. When clicking "arrow down" the curves move up, when clicking "arrow up" the curves move down.
  • "Lower limit" - a button for changing the lower limit. When clicking "arrow down" the curves move up, when clicking "arrow up" the curves move down.

  With the help of these buttons you can take out of the graph those parts of the curve which can distort the session picture.

  Below the pulsogram there are located the buttons for changing the curves got at this session:

  • "Exclude artifacts" - a button for exclusion of the parts, which go out of the set upper and lower limits.
  • "Cancel exclusions" - a button for restoring the excluded artifacts.

  6. With the help of the right button of the mouse you can scale the horizontal axis.

  7. How to estimate the results you will get to know from §§13-16.

  Special terms:

  A plot of heart rate versus time are the heart rate variations recorded during the session (background, periods of work and periods of rest).

  Artifacts are the heart rate values that are recorded erroneously and so, they misrepresent the session pattern.

§12. Biofeedback training sessions

  To make the greatest and quickest progress towards strengthening your health you are advised to follow the following stages of training:

  • Stage 1. Mastering abdominal breathing (Part 1,§6). It takes a session and is carried out without the Trainer.
  • Stage 2. Learning to work with the Trainer (1-2 sessions)
  • Stage 3. Developing diaphragmatic relaxation breathing with the help of RSA biofeedback (2-3 sessions)
  • Stage 4. Acquiring a habit of diaphragmatic relaxation breathing with the help of RSA biofeedback (5-6 sessions).
  • Stage 5. Consolidation of the acquired habit of diaphragmatic relaxation breathing (2-3 sessions).

    §13. Stage 2. Learning to work with the Trainer "Breathing"(1-2 sessions)

  Objectives are:

  • To acquire diaphragmatic relaxation breathing with the help of the Biofeedback trainer "Breathing".
  • To learn to set the thresholds for RSA values or to set session conditions on your own.
  • To learn to exhale so that the heart rate decreased during exhalation.
  1. Before sessions you are advised to study how to work with the Trainer, soft ware "Breathing 1.1" and biofeedback procedure.
  2. Start biofeedback session (part 1, §9).
  3. Select a program version (part 2, §5). Versions NoNo 1-2 are advisable.
  4. Set the thresholds during the first work period of the version (part 1, §10).
  5. During the second work period start breathing effortlessly with your abdomen.
  6. If the task of a situation is not accomplished (the bar does not go down to the end, the brush does not paint the fence down to the bottom, etc.) adjust the thresholds (part 2, §8, point 4).
  7. Go on training to the completion of the version paying attention to abdominal movements and decrease of the heart rate during an exhalation.
  8. On finishing the session view the results, delete artifacts (part 2, §11, point 5) and save the results.
  9. Click "Close" and exit to the main menu (part2, §10).

    §14. Stage 3. Developing diaphragmatic relaxation breathing with the help of RSA biofeedback (2-3 sessions).

  Objectives are:

  • To acquire and consolidate a habit of breathing with the diaphragm.
  • To learn to confidently decrease the heart rate during exhalation.

  1. Carry out sessions with the versions NoNo 3-7.

  2. Your attention should be paid to your sensations during the correct diaphragmatic breathing.

  3. Remember: You begin to form a new pattern of breathing. The main thing is exhalation. See particularly to its duration, smoothness, and uniformity. At the end of every exhalation the tone of auditory feedback should become broken ("Bar") and the bar should go down to the bottom. In the "Fence" situation the brush should paint the fence down to the bottom.

  A new stable link begins to be formed at the central nervous system: "During exhalation the bar (the brush) goes down, the pitch of the tone decreases and becomes broken. It means that during exhalation the heart rate decreases and becomes less than the lower threshold. Therefore I am breathing correctly."

  4. During a session your thoughts concern only your performing breathing exercises.

  5. If the heart rate average value increases for any reason (for example, suddenly you have recollect something unpleasant) and the task is not accomplished, stop the session and calm down for a few minutes. Then go on exercising after setting the thresholds according to the new heart rate average value.

  6. In viewing the results compare the indices of:

  • the session and the basic minute;
  • work and rest periods;
  • the basic minute and the last work period.

  7. Criteria for appreciation are:

  • decrease of the minimal and average heart rate at the end of the session;
  • increase of RSA during the work periods in comparison with the rest periods;
  • decrease of the breath rate during the work periods in comparison with the rest periods.

    §15. Stage 4. Acquiring a habit of diaphragmatic relaxation breathing with the help of RSA biofeedback (5-6 sessions).

  Objectives are:

  • To harmonize the respiration and cardiovascular systems functioning. This is one of the most important objectives of the biofeedback-training course. When this objective having been attained the RSA value is the maximum for your organism.
  • To reduce the heart rate and the breath rate, to increase RSA. Compare the results of the sessions. The heart rate will decrease from session to session. You will see that RSA increases and the breath rate decreases. Within four-six sessions these indices will be optimal for your organism.
  • To learn to use the new pattern of breathing without biofeedback.
  1. Carry out the sessions with the versions NoNo 8-12.
  2. Do not worry and feel nervous if you can not attain good results at once. Remember that the less efforts the more results. You should be more comfortable and more relaxed and you will soon make sure that the results will exceed your expectations.
  3. Remember what you feel while breathing successfully. This will help you produce this pattern of breathing without biofeedback.
  4. Go on breathing diaphragmatically during the rest periods. Then compare the results and be convinced of steadiness of the acquired habit.

    §16. Stage 5. Consolidation of the acquired habit of diaphragmatic relaxation breathing (2-3 sessions).

  Objectives are:

  • Consolidating the acquired habit of diaphragmatic relaxation breathing.
  • Producing the acquired habit without biofeedback.
  1. Use the versions NoNo 9-12. During these sessions the work periods are increased up to 4 minutes. The rest periods are 2 minutes each.
  2. We advise to carry out sessions daily.
  3. Carry out sessions alternating exercising with the biofeedback trainer "Breathing" and breathing without biofeedback.
  4. Breathe with your abdomen in any posture: "sitting", "lying", "standing", and "walking" while remembering your feelings during work periods.
  5. Make a point of respiration training for ten minutes according to Smetankin method every morning after sleep and every evening before bed.
  6. Apply this respiration pattern in stress situations to reduce psycho-emotional tension.

  Important!

  Do not wonder if you have stopped suffering from headaches or symptoms of that disease, which worried you for many months, eased or disappeared. This is a favourable influence of the diaphragmatic relaxation breathing.

  While your health improving you should not stop taking your medication on your own. Only your doctor can decrease the medication doses.

  After this biofeedback training course:

  • You will be seldom ill.
  • You will be able to quickly decrease psycho-emotional tension.
  • Probability of your falling ill with hypertension, stomach ulcer or neurotic disorders will significantly reduce.

 

 

Part 3. Working with the Trainer "Breathing" without a computer

 

§1. Biofeedback training sessions

  To make the greatest and quickest progress towards strengthening your health you are advised to follow the following stages of training:

  • Stage 1. Mastering abdominal breathing (Part 1, §6). It takes a session and is carried out without the Trainer.
  • Stage 2. Learning to work with the Trainer (1-2 sessions)
  • Stage 3. Developing diaphragmatic relaxation breathing with the help of RSA biofeedback (3-5 sessions)
  • Stage 4. Acquiring and consolidation of a habit of diaphragmatic relaxation breathing with the help of RSA biofeedback (5-6 sessions).

  Important!

  Write down the heart rate values of every session.

  For example: Date; the average heart rate before the session; the minimal heart rate during the session; maximal RSA during the session; the average heart rate after the session.

§2. Stage 2. Learning to work with the Trainer "Breathing"(1-2 sessions)

  Objectives are:

  • To acquire diaphragmatic relaxation breathing with the help of the Biofeedback trainer "Breathing".
  • To learn to set the thresholds for RSA values or to set session conditions on your own.
  • To learn to exhale so that the heart rate decreased during exhalation.
  1. Before sessions you are advised to study how to work with the Trainer and biofeedback procedure.
  2. Attach the sensors to the chest, connect the sensors to the cardiosignalizer, switch on the cardiosignalizer, set the thresholds (Part 1, §§8-10).
  3. Start the biofeedback session. Breathe with your abdomen watching the light bar of the cardiosignalizer. See if you can synchronize a breathing cycle with the heart rate oscillations. During an inhalation the heart rate increases (the light spot moves up to the top) and during an exhalation the heart rate decreases (the light spot moves down to the bottom).
  4. The heart rate changes all the time. So, one should correct the thresholds to attain them without great difficulties. It is important not to increase the depth of inhalation. An inhalation has to be calm and short. During an exhalation one should relax and attain the minimal heart rate. The more comfortable is the patient the better.
  5. The duration of the first session is no more than 10 minutes. It consists of alternating 3-minute periods of training and 2-minute rest periods when you breathe relaxing.

    §3. Stage 3. Developing diaphragmatic relaxation breathing with the help of RSA biofeedback (3-5 sessions).

  Objectives are:

  • To acquire and consolidate a habit of breathing with the diaphragm.
  • To learn to confidently decrease the heart rate during exhalation.

  1. The sessions of the stages 3 and 4 are carried out for 20 minutes each.

  2. You can begin a session from both the work-period and the rest-period. It depends on your condition before the session. If you are excited or have just exercised start the session with a rest-period and then pass to the biofeedback training.

  3. We suggest the following procedure of the second and the next sessions:

- 3 minutes - biofeedback training, 2 minutes - rest;

- 3 minutes - biofeedback training, 2 minutes - rest;

- 3 minutes - biofeedback training, 2 minutes - rest;

- 3 minutes - biofeedback training.

  4. Taking into account the person's age and diligence during the next sessions you should gradually increase the work periods at first in one cycle, then in the all cycles of the session (a cycle is equal to a work period plus a rest period). It is not advisable to change the rest period duration, as two minutes are the optimum time.

  5. It is good practice to carry out the sessions daily or every other day. After every session the person must exercise on his own without the cardiosignalizer.

§4. Stage 4. Acquiring and consolidation of the habit of diaphragmatic relaxation breathing with the help of RSA biofeedback (4-6 sessions).

  Objectives are:

To harmonize the respiration and cardiovascular systems functioning. This is one of the most important objectives of the biofeedback-training course. This objective having been attained the RSA value is the maximum for your organism.

  • To reduce the heart rate and the breath rate, to increase RSA. Compare the results of the sessions. The heart rate will decrease from session to session. You will see that RSA increases and the breath rate decreases. Within four-six sessions these indices will be optimal for your organism.
  • To learn to use the new pattern of breathing without biofeedback.
  • To Consolidate the acquired habit of diaphragmatic relaxation breathing.

  1. The new pattern of breathing is developed. You should consolidate it. We can suggest the following procedure:

  • 3 minutes - biofeedback training, 2 minutes - rest;
  • 4 minutes - biofeedback training, 2 minutes - rest;
  • 4 minutes - biofeedback training, 2 minutes -rest;
  • 3 minutes - biofeedback training.

  2. If there is possibility to train for the longer time without break for the rest, you can increase the training period by shortening the time for rest or by increasing the quantity of cycles in the session. If you have time you can prolong the session up to 25-30 minutes. Once again we emphasis that the principal object of the work with the device is to achieve synchrony of breathing phases and heart rate fluctuations.

  3. We advise to carry out sessions daily.

  4. Carry out sessions alternating exercising with the biofeedback trainer "Breathing" and breathing without biofeedback.

  5. Breathe with your abdomen in any posture: "sitting", "lying", "standing", and "walking" while remembering your feelings during work periods.

  6. Make a point of respiration training for ten minutes according to Smetankin method every morning after sleep and every evening before bed.

  7. Apply this respiration pattern in stress situations to reduce psycho-emotional tension.

  Important!

  Do not wonder if you have stopped suffering from headaches or symptoms of that disease, which worried you for many months, eased or disappeared. This is a favourable influence of the diaphragmatic relaxation breathing.

  While your health improving you should not stop taking your medication on your own. Only your doctor can decrease the medication doses.

  After this biofeedback training course:

  • You will be seldom ill.
  • You will be able to quickly decrease psycho-emotional tension.
  • Probability of your falling ill with hypertension, stomach ulcer or neurotic disorders will significantly reduce.

 

 

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