PAMLE workshop: Applications of Biofeedback and Neurofeedback in Neurorehabilitation – Theoretical Framework, Research, and Practical Implementation

Neurofeedback and biofeedback represent innovative neuromodulation methods that enable individuals with neurological impairments to actively participate in their own rehabilitation by training self-regulation abilities. These feedback modalities are based on real-time recording of physiological signals—such as EEG activity, heart rate variability (HRV), muscle tension (EMG), and skin conductance (GSR)—and guide users towards optimal patterns of functioning.

In neurorehabilitation, particularly after traumatic brain injury (TBI), an increasing number of studies confirm the effectiveness of EEG neurofeedback and biofeedback protocols. Randomized controlled trials show improvements in attention, short-term memory, visuospatial skills, and functional integration through these methods. MRI studies have confirmed structural changes in white and gray matter following neurofeedback training, while biofeedback interventions (e.g., HRV biofeedback) have demonstrated significant reductions in anxiety, improved autonomic balance, and greater stress resilience in individuals with neurological damage.

Systematic reviews highlight the importance of combining multiple biofeedback modalities in therapy to achieve long-term outcomes. Despite methodological challenges (lack of standardized protocols and sham controls), current evidence and clinical experience confirm that neurofeedback and biofeedback can be successfully integrated into individualized rehabilitation plans, especially in the domains of attention, emotional regulation, and sensorimotor control.