Urinary incontinence Mowrer detailed the use of a bedwetting alarm that sounds when children urinate while asleep. This simple<unk>  device can quickly teach children to wake up when their bladders are full and to contract the urinary sphincter and relax the detrusor muscle, preventing further urine release. Through classical conditioning, sensory feedback from a full bladder replaces the alarm and allows children to continue sleeping without urinating. Kegel developed the perineometer in 1947 to treat urinary incontinence (urine leakage) in women whose pelvic floor muscles are weakened during pregnancy and childbirth. The perineometer, which is inserted into the vagina to monitor pelvic floor muscle contraction, satisfies all the requirements of a<unk>  device and enhances the effectiveness of popular Kegel exercises. Contradicting this, a 2013 randomized controlled trial found no benefit of adding<unk>  to pelvic floor muscle exercise in stress urinary incontinence. In another randomized controlled trial the addition of<unk>  to the training of pelvic floor muscles for the treatment of stress urinary incontinence, improved pelvic floor muscle function, reduced urinary symptoms, and improved of the quality of life. In 1992, the United States Agency for Health Care Policy and Research recommended<unk>  as a first-line treatment for adult urinary incontinence. In 2019, the National Institute for Health and Care Excellence recommended against the routine use of use<unk>  in managing urinary incontinence in women who can actively contract the pelvic floor. It may be considered though, to aid motivation and adherence to therapy. Fecal incontinence, constipation and anismus<unk>  is a treatment for anismus (paradoxical contraction of puborectalis during defecation). This therapy directly evolved from the investigation anorectal manometry where a probe that can record pressure is placed in the anal canal.<unk>  therapy is also a commonly used and researched therapy for fecal incontinence, but the benefits are uncertain.<unk>  therapy varies in the way it is delivered. It is also unknown if one type has benefits over another. The aims have been described as to enhance either the rectoanal inhibitory reflex (RAIR), rectal sensitivity (by discrimination of progressively smaller volumes of a rectal balloon and promptly contracting the external anal sphincter (EAS)), or the strength and endurance of the EAS contraction. Three general types of<unk>  have been described, though they are not mutually exclusive, with many protocols combining these elements. Similarly there is variance of the length of both the individual sessions and the overall length of the training, and if home exercises are performed in addition and how. In rectal sensitivity training, a balloon is placed in the rectum, and is gradually distended until there is a sensation of rectal filling. Successively smaller volume reinflations of the balloon aim to help the person detect rectal distension at a lower threshold, giving more time to contract the EAS and prevent incontinence, or to journey to the toilet. Alternatively, in those with urge incontinence/ rectal hypersensitivity, training is aimed at teaching the person to tolerate progressively larger volumes. Strength training may involve electromyography (EMG) skin electrodes, manometric pressures, intra-anal EMG, or endoanal ultrasound. One of these measures are used to relay the muscular activity or anal canal pressure during anal sphincter exercise. Performance and progress can be monitored in this manner. Co-ordination training involves the placing of 3 balloons, in the rectum and in the upper and lower anal canal. The rectal balloon is inflated to trigger the RAIR, an event often followed by incontinence. Co-ordination training aims to teach voluntary contraction of EAS when the RAIR occurs (i.e. when there is rectal distension). There is some research that shows the effects of<unk>  on irritable bowel syndrome. However, there may be some adverse effects when using these devices. In 2010 and 2017, the National Institute for Health and Care Excellence recommended against the use of<unk>  in managing constipation in children. EEG Caton recorded spontaneous electrical potentials from the exposed cortical surface of monkeys and rabbits, and was the first to measure event-related potentials (EEG responses to stimuli) in 1875. Danilevsky published Investigations in the Physiology of the Brain, which explored the relationship between the EEG and states of consciousness in 1877. Beck published studies of spontaneous electrical potentials detected from the brains of dogs and rabbits, and was the first to document alpha blocking, where light alters rhythmic oscillations, in 1890. Sherrington introduced the terms neuron and synapse and published the Integrative Action of the Nervous System in 1906. Pravdich-Neminsky photographed the EEG and event related potentials from dogs, demonstrated a 12–14 Hz rhythm that slowed during asphyxiation, and introduced the term electrocerebrogram in 1912. Forbes reported the replacement of the string galvanometer with a vacuum tube to amplify the EEG in 1920. The vacuum tube became the de facto standard by 1936. Berger (1924) published the first human EEG data. He recorded electrical potentials from his son Klaus's scalp. At first he believed that he had discovered the physical mechanism for telepathy but was disappointed that the electromagnetic variations disappear only millimeters away from the skull. (He did continue to believe in telepathy throughout his life, however, having had a particularly confirming event regarding his sister). He viewed the EEG as analogous to the ECG and introduced the term elektenkephalogram. He believed that the EEG had diagnostic and therapeutic promise in measuring the impact of clinical interventions. Berger showed that these potentials were not due to scalp muscle contractions. He first identified the alpha rhythm, which he called the Berger rhythm, and later identified the beta rhythm and sleep spindles. He demonstrated that alterations in consciousness are associated with changes in the EEG and associated the beta rhythm with alertness. He described interictal activity (EEG potentials between seizures) and recorded a partial complex seizure in 1933. Finally, he performed the first QEEG, which is the measurement of the signal strength of EEG frequencies. Adrian and Matthews confirmed Berger's findings in 1934 by recording their own EEGs using a cathode-ray oscilloscope. Their demonstration of EEG recording at the 1935 Physiological Society meetings in England caused its widespread acceptance. Adrian used himself as a subject and demonstrated the phenomenon of alpha blocking, where opening his eyes suppressed alpha rhythms. Gibbs, Davis, and Lennox inaugurated clinical electroencephalography in 1935 by identifying abnormal EEG rhythms associated with epilepsy, including interictal spike waves and 3 Hz activity in absence seizures. Bremer used the EEG to show how sensory signals affect vigilance in 1935. Walter (1937, 1953) named the delta waves and theta waves, and the contingent negative variation (CNV), a slow cortical potential that may reflect expectancy, motivation, intention to act, or attention. He located an occipital lobe source for alpha waves and demonstrated that delta waves can help locate brain lesions like tumors. He improved Berger's electroencephalograph and pioneered EEG topography. Kleitman has been recognized as the "Father of American sleep research" for his seminal work in the regulation of sleep-wake cycles, circadian rhythms, the sleep patterns of different age groups, and the effects of sleep deprivation. He discovered the phenomenon of rapid eye movement (REM) sleep with his graduate student Aserinsky in 1953. Dement, another of Kleitman's students, described the EEG architecture and phenomenology of sleep stages and the transitions between them in 1955, associated REM sleep with dreaming in 1957, and documented sleep cycles in another species, cats, in 1958, which stimulated basic sleep research. He established the Stanford University Sleep Research Center in 1970. Andersen and Andersson (1968) proposed that thalamic pacemakers project synchronous alpha rhythms to the cortex via thalamocortical circuits. Kamiya (1968) demonstrated that the alpha rhythm in humans could be operantly conditioned. He published an influential article in Psychology Today that summarized research that showed that subjects could learn to discriminate when alpha was present or absent, and that they could use feedback to shift the dominant alpha frequency about 1 Hz. Almost half of his subjects reported experiencing a pleasant "alpha state" characterized as an "alert calmness." These reports may have contributed to the perception of alpha<unk>  as a shortcut to a meditative state. He also studied the EEG correlates of meditative states. Brown (1970) demonstrated the clinical use of alpha-theta<unk> . In research designed to identify the subjective states associated with EEG rhythms, she trained subjects to increase the abundance of alpha, beta, and theta activity using visual feedback and recorded their subjective experiences when the amplitude of these frequency bands increased. She also helped popularize<unk>  by publishing a series of books, including New Mind, New body (1974) and Stress and the Art of<unk>  (1977). Mulholland and Peper (1971) showed that occipital alpha increases with eyes open and not focused, and is disrupted by visual focusing; a rediscovery of alpha blocking. Green and Green (1986) investigated voluntary control of internal states by individuals like Swami Rama and American Indian medicine man Rolling Thunder both in India and at the Menninger Foundation. They brought portable<unk>  equipment to India and monitored practitioners as they demonstrated self-regulation. A film containing footage from their investigations was released
Biofeedback
Neurofeedback
Functional electrical stimulation
Autogenic training
Baroreflex activation therapy
Constraint-induced movement therapy
Myofascial release
Frenkel exercises