How biofeedback improves physical therapy results

You may have seen images of athletes you admire wired up to various high-tech devices as they go through their training sessions. These devices are giving the athlete and their coaches and physical therapists (PTs) biofeedback: critical information on how their body is performing, inside and out, so they can continuously evolve their training program.

You may have thought to yourself; why do they need all these fancy devices? Why don’t they just practice in front of a mirror?

Whether you’re an athlete trying to perform at your peak or a regular person trying to overcome pain, it’s important that you move your body in just the right way.

For athletes, tiny increments in movement can be the difference between taking home Olympic gold and not even qualifying, nuances that mirrors (and our brains) can’t reliably recognize. For regular people, these tiny tweaks can be the difference between resolving pain and making it worse.

Our FDA-listed sensor technology detects how a body is moving more precisely than human eyes, giving you feedback on how you’re moving in real time, and giving your PT important insight to help them guide you better.

First let's tackle some definitions and the difference between biofeedback in physical therapy and other contexts.

What is biofeedback?

So, what is biofeedback, exactly? Biofeedback is a mind-body technique that uses sensors and devices to measure your body’s physiological signals like muscle tension, heart rate, or breathing patterns. The device feeds this information back to you in real time.

This awareness empowers you to make small, intentional changes that can improve your health and performance. In physical therapy, this means seeing how your muscles fire and move, helping you correct patterns that may be causing pain or holding you back.

What is biofeedback therapy?

Think of biofeedback therapy as guided training that helps you gain better control over your body’s involuntary functions. It’s used in various fields from physical therapy and pain management to stress reduction and mental health.

Biofeedback in physical therapy

Biofeedback therapy focuses on muscle activation and movement patterns, giving you and your clinician actionable insights to help you heal faster, with fewer setbacks.

Biofeedback in psychology

Biofeedback in psychology helps people manage stress, anxiety, or chronic conditions like migraines. By seeing real-time feedback on things like heart rate or skin temperature, people learn to calm their bodies and minds.

For example, someone with chronic stress might use biofeedback to learn how to relax tight muscles or slow their breathing, supporting overall mental well-being alongside talk therapy.

Can biofeedback check for cognitive impairment?

The short answer is no, not directly.

While biofeedback can help track physiological data like brainwaves or heart rate variability, diagnosing cognitive impairment usually involves more complex neuropsychological assessments and medical imaging.

However, certain types of biofeedback, like neurofeedback, can be used as a supportive tool for cognitive training or stress management, which can indirectly benefit cognitive health.

Here’s why biofeedback works so well.

Biofeedback gets your unreliable brain out of the driver’s seat

The world’s best athletes have come to trust technology over their own brains for two reasons.

1. Your brain isn’t fully conscious of the way you’re moving

Once you’ve learned a movement pattern, it becomes ingrained. This is true even if it’s not the best one, or the most efficient.

Even elite athletes whose job it is to be hyper-conscious of their movements struggle to understand what’s really going on in their bodies. Their coach or their physical therapist (PT) can correct some of this, but only as much as they can observe.

2. Our brains take time to adapt

Even if our reflexes are super quick, information takes time to travel from our eyes, ears, muscles and tendons to our brain, be processed, and travel back down. We are talking milliseconds here, but enough to render mirrors, and our own judgement, unreliable.

This is true for us mere mortals, too. If you know anyone who has been injured since they started a home workout routine in quarantine, this might be why. Watching videos on youtube or a trainer on Zoom can do wonders to motivate you to exercise, but they can’t help you correct your movements. And this is of crucial importance when you’re in pain, because your movement pattern needs to be corrected and pain changes how you move.

Our digital therapist overrides our unreliable brains and bodies by tracking exactly how you’re moving, and it’ll tell you when you’re doing it wrong. If you’ve been making the wrong move for years, the first few attempts may be frustrating as your body and brain learn new movement patterns, but eventually they’ll learn new habits that can benefit you for a lifetime.

Biofeedback helps your PT see how you’re performing

If you have done in-person physical therapy, you might have taken home a piece of paper with a bunch of exercises on it. If you’re super conscientious, you may have stuck that piece of paper on your fridge and done the whole exercise routine five times a week as prescribed by your PT. If that’s you, congratulations. The problem is that you’re in a serious minority.

Fewer than 30% of people actually engage in their exercise program between sessions. The large majority of us don’t do anything with that little piece of paper.

This is common, and a real point of frustration for physical therapists. Therapeutic exercise is the cornerstone of a PT program, and when you don’t do your exercises, you don’t get better. Our medical device effectively serves as the eyes and ears of your PT, allowing them to monitor your movements from afar.

This is necessary for a digital solution, as it’s impossible to tell whether someone is moving in the right way through a phone camera. But unlike in the clinic, where the PT gets feedback on how you’re moving during your appointments but not between visits, our digital therapist sends data on how you’re moving every single time you complete a session. When our PTs join Sword, many of them are blown away by the amount of feedback they get.

Your PT can use this information to evolve your program: add or subtract exercises, and make them easier or harder, depending on how you’re progressing from day to day. Our PTs make adjustments to members’ programs between 2 and 4 times per week on average, which helps our members get better faster.

When you know you’re being watched, you perform better

Remember that exercise program your PT gave you at the clinic? When you got to your next session, what happened? Did you admit to your PT that that little piece of paper was still in your bag, untouched? Or did you tell them a little white lie? More importantly, did the therapy program work? Did you get better, or does that pain still rear its ugly head from time to time?

When there’s nobody watching, it’s harder to get motivated to put in the work and it's easier to bend the truth than to bend your back.

\Your PT will never know, right?

Wrong! We always know when people are lying about doing their exercises, because they’re not improving.

The Hawthorne effect means digital PT increases engagement and adherence rates

But as soon as you know we’re being monitored, everything changes.

All of a sudden, you’re doing your exercises five times a week. This is known as the Hawthorne effect: our tendency to work harder when we know someone’s watching.

If you have a smartwatch or ring, or track your workouts on an app, you may be familiar with this effect.

• Does tracking your run or bike ride on Strava help you go faster?
• Does tracking your sleep make you prioritize it?
• Do you complete your workouts even when you don’t want to because every time you work out, your Apple Watch sends a notification to your friends?

These are all examples of the Hawthorne effect at work.

At Sword, our digital therapist sends the results of every exercise session to your PT, and they can not only see that you completed a session, but exactly how your body was moving through every rep, helping keep you accountable. That’s why our digital therapist is so effective.

In fact, in clinical studies, Sword’s program achieved 30% better results than conventional PT.

The power of biofeedback therapy

Whether you’re a high-performance athlete or someone working to overcome pain, biofeedback therapy can bridge the gap between what your body is doing and what your mind thinks it’s doing.

By combining the science of sensors with the art of physical therapy, you get a level of precision and personalization that simply isn’t possible through observation alone. It’s just one more way technology is empowering people to take control of their recovery and perform at their best.

If you're interested in using digital biofeedback to help with injury recovery, injury prevention, mobility training, or high performance, make sure you consider Sword Health's revolutionary AI physical therapy.