Hernando Ponce Burgos, M.D.  
Frequently Asked Questions
Panama Biofeedback Center
Panama Biofeedback Center

The Panama Biofeedback Center at the Centro Especializado Paitilla is the most sophisticated center of its type in Latin America, implementing new and innovative behavioral procedures and advanced microprocessor technology for the purpose of restoring function to people who have paralysis from central nervous system damage, such as individuals with strokes, brain injuries, Cerebral Palsy, brain tumors and spinal cord injuries or damage. The Panama Biofeedback Center is a project developed by the Lucy Tzanetatos Neurological Foundation and Dr. Luis Pretto Malca Pain Treatment Center. The Panama Biofeedback Center uses a learning procedure developed by Dr. Bernard Brucker, the Director and creator of the Biofeedback Laboratory in Miami, Florida, which is based on operant conditioning and is designed to teach an individual to utilize motor cells in the brain, brain stem and spinal cord more efficiently. This method has become known as the "Brucker Method".

The central nervous system is comprised of the brain, brain stem and spinal cord. The cells in the central nervous system are permanent cells. They are primarily formed before birth and are designed to last the lifespan of an individual. If these cells should be destroyed from a stroke, brain injury, Cerebral Palsy, or spinal cord injury for example, the body will not be able to replace them. This is why people who suffer damage to the brain, brain stem, or spinal cord from accident or disease resulting in paralysis, usually gain some improvement from rehabilitation in the first six months to one year, but will normally have some permanent disability for the remaining lifespan. Recent findings from the neurological and behavioral sciences have shown that some people experience long term repair within the brain, brain stem or spinal cord after damage, which was previously thought to only occur in the first six months to one year. Further, it has also been discovered that the brain, brain stem and spinal cord have many extra cells that are not normally used during the lifespan. Under the right conditions, it has been shown that these alternate cells can be "Used to take over the function of damaged or destroyed cells.

The procedures in the Panama Biofeedback Center are specifically designed to teach an individual to find and utilize long term repairing and remaining cells after damage as a way of restoring function. Surface electrodes are placed over the muscles which have limited or no function. These electrodes do not provide any stimulation, but actually receive the motor neuron activity from the brain, brain stem and spinal cord as it arrives at the muscle site. These electrodes are connected to specially designed computers which process these motor signals accurately and rapidly and present them on a monitor in front of the person. In this way, an individual can actually see how they are utilizing brain, brain stem and spinal cord cells which would normally be unknown to the individual, doctor or therapist. Even small amounts of motor neuron activity are detectible from this system.

This information is then used in the context of learning paradigms to allow the individual to find alternate surviving cells in the brain, brain stem, or spinal cord and connect them to the muscle site. In cases where there are minimal motor neuron signals to muscles, resulting in weak or non-functional muscles, this procedure can teach an individual how to make more efficient use of remaining cells in order to obtain a greater motor neuron connection to the muscle, which will then allow it to be strengthened, In cases where the problem is coordination of muscle groups which prevent, function, this procedure can teach an individual how to utilize central nervous system cells in a more efficient manner by having the brain isolate motor neurons to specific muscle groups in coordinated functional patterns. Once learned, these increases in motor neuron recruitment and coordination of motor neuron recruitment will be permanent.

It is important to understand that these procedures do not take the place of physical and occupational therapy procedures, but rather add a unique aspect of treatment, designed to work at the neurological level, which is not present in other therapies. Once an individual gains greater and better coordinated motor neuron recruitment to affected muscles, these muscles can first respond to other therapeutic procedures, even - though they may have previously stopped responding to these treatments. The length of time since damage to the central nervous system is not a factor for this application, since the procedures work with the remaining undamaged cells of the central nervous system, which are unrelated to time of damage.

To date, Dr. Brucker's Biofeedback Program has had experience with over 10,000 cases at the Biofeedback Laboratory in Miami with a 98% success rate of restoring at least one level of function. These cases are adults and children who are facing permanent paralysis from damage to the brain, brain stem, or spinal cord, resulting from strokes, brain injuries, Cerebral Palsy, brain tumors, brain stem injuries, spinal cord injuries, certain neurological diseases and other types of central nervous system damage. The time since the damage to the central nervous system is not a factor and the age of the person is not a factor, although generally, the procedures are not usually applied to individuals younger than five years old. There is no upper age limit for response to this treatment. Since the work: is on motor learning, an individual's verbal cognitive abilities are not usually a factor. Overall, the Biofeedback Program has been able to increase function and improve the quality of life for many people who would normally be facing permanent paralysis.

Staff Members:
Panama Program Director
Specialty - Anesthesiology, Pain Medicine

Specialty - Adult and Geriatric Psychiatry

Physical Therapist