Comparison of Electromyography Responses in Spinal Cord Injury Patients Using an Operant Conditional Protocol Treatment

Abstract

Background Electromyography (EMG) biofeedback has been used in spinal cord injury rehabilitation, but optimal indication and treatment protocols still need to be identified. Objectives To use an operant conditioning learning paradigm to compare the EMG responses in subjects with spinal cord injury for optimal indication of EMG biofeedback treatment. Participants Thirty rehabilitation outpatients with incomplete cervical spinal cord injury. The subjects were divided into three groups based on their scores on the ASIA scale (ASIA B, ASIA C and ASIA D groups), with ten patients in each group. Methods Repeated-measure trials were conducted to compare patients’ EMG responses between pre-initial and post-biofeedback treatment. In the sessions, visual feedback of EMG activity of the triceps brachii muscle was provided to the patient in accordance with the treatment protocol. Results One-way ANOVA and the Kruskal-Wallis test were used to examine the differences in the measures between groups. The initial EMG and final EMG measures were not significantly different between the ASIA C and D groups, but these measures were different between the ASIA B group and the ASIA C and D groups. In the ASIA B group, the EMG responses started out lower than those in the other groups and varied less, especially in comparison to the ASIA C group. Conclusion: These results reveal that the patients classified as ASIA C and D achieved better responses of the operant conditional learning protocol and optimal indication for the biofeedback treatment.