Electromyographic Biofeedback Therapy Research Articles

Study on the treatment of dysphagia after stroke with electromyographic biofeedback intensive training.

Dysphagia, or swallowing disorder, is a common complication following stroke, significantly impacting patients' quality of life. Electromyographic biofeedback (EMGBF) therapy has emerged as a potential rehabilitation technique to improve swallowing function, but its efficacy in comparison with conventional treatments remains to be further explored. To investigate the effects of different treatment intensities of EMGBF on swallowing function and motor speed after stroke. The participants were divided into three groups, all of which received routine neurological drug therapy and motor function rehabilitation training. On the basis of routine swallowing disorder training, the EMGBF group received additional EMGBF training, while the enhanced EMGBF group received two additional training sessions. Four weeks before and after treatment, the degree of swallowing disorder was evaluated using the degree of swallowing disorder score (VGF) and the Rosenbek penetration-aspiration scale (PAS). Initially, there was no significant difference in VGF and PAS scores among the groups (P > 0.05). After four weeks, all groups showed significant improvement in both VGF scores and PAS scores. Furthermore, the standardized swallowing assessment and videofluoroscopic dysphagia scale scores also improved significantly post-treatment, indicating enhanced swallowing function and motor function of the hyoid-bone laryngeal complex, particularly in the intensive EMGBF group. EMGBF training is more effective than traditional swallowing training in improving swallowing function and the movement rate of the hyoid laryngeal complex in patients with post-stroke dysphagia.

Electromyographic biofeedback therapy for improving limb function after stroke: A systematic review and meta-analysis.

Upper and lower limb impairment is common after stroke. Electromyographic biofeedback therapy is a non-invasive treatment, and its effectiveness in functional rehabilitation of the limb after stroke still remains uncertain. The objective of this study was to evaluate whether electromyographic biofeedback can improve upper and lower limb dysfunction in stroke patients. PubMed, Embase, Cochrane Library, and Physiotherapy Evidence Database (PEDro) were searched from inception to 1st May 2022. Inclusion criteria were randomized controlled clinical trials of electromyographic biofeedback therapy interventions reporting changes in upper and lower limb function in post-stroke patients. Data were extracted by two independent reviewers and pooled in random-effects models using Review manager (RevMan) software. Our analyses included 10 studies enrolling a total of 303 participants. Electromyographic biofeedback therapy can effectively improve limb function after stroke (standardized mean difference [SMD], 0.44; 95% confidence interval [CI], 0.12-0.77; P = 0.008) and in subgroup analyses, the effect sizes of short-term effect (SMD, 0.33; 95% CI, 0.02-0.64; P = 0.04) was significant, but the long-term was not (SMD, 0.61; 95% CI, -0.11-1.33; P = 0.10). In addition, Electromyographic biofeedback therapy can improve the active range of motion of shoulder (SMD, 1.49; 95% CI, 2.22; P<0.0001) and wrist joints (SMD, 0.77; 95% CI, 0.13-1.42; P = 0.02) after stroke. In this meta-analysis, electromyographic biofeedback therapy intervention can improve upper and lower limb function in patients with stroke. Short-term (less than one month) improvement after electromyographic biofeedback therapy was supported, while evidence for long-term (more than one month) benefits was lacking. Range of motion in the glenohumeral and wrist joints were improved. Stronger evidence for individualized parameters, such as optimal treatment parameters and intervention period, is needed in the future. [https://www.crd.york.ac.uk/prospero/display_record.php?recordID=267596], identifier [CRD42022354363].

Physiotherapy in rehabilitation of patients with urinary incontinence after radical prostatectomy

The leading treatment for prostate cancer is radical prostatectomy with variations of access to the affected organ which leads to urinary incontinence in the postoperative period. In order to treat this complication, conservative methods, including a wide range of physical factors, are used. The purpose of the article is to conduct an analytical review of the literature on physical methods of treating urinary incontinence in patients with prostate cancer after radical prostatectomy. Materials. The review included data from the following electronic databases: Scopus, Web of Science, MedLine, Wiley, World Health Organization, the Cochrane Central Register of Controlled Trials, ScienceDirect, PubMed, eLibrary, CyberLeninka, and disserCat. Results. The research databases include various methods of exercises for the pelvic floor muscles with or without using the method of electromyographic biofeedback, Pilates, general, local, and penile vibratory therapy, transanal, pudendal, and tibial electrical stimulation, electrical stimulation of the pelvic floor muscles and bladder, and extracorporeal magnetic stimulation. Conclusion. It seems impossible to determine the most effective method of rehabilitation due to the large variability of treatment protocols, sample sizes, timing of the start of procedures, techniques, and assessment time points. No study has data on the patients’ catamnesis. Further studies and the search for a drug-free non-invasive method of physical therapy for the rehabilitation of prostate cancer patients who have undergone radical prostatectomy are justified.

Effectiveness of Rehabilitation in Patients with Guillain-Barre Syndrome: a Systematic Review of the Literature

Background. Guillain-Barre syndrome is an immune-mediated polyradiculoneuropathy characterized by acute neurological symptoms, usually following an infectious disease. The discovery of links between coronavirus infection and GBS has made the analysis even more relevant. The aim. To evaluate the efficacy of rehabilitation for patients with GuillainBarre syndrome (GBS). Methods. A systematic literature review was performed according to PRISMA statement. A literature search had begun on January 10, 2022, and ended on May 1, 2022. The search was performed in Pubmed, ScienceDirect, and ClinicalKey databases. Inclusion criteria were research articles published less than five years ago, written in English, evaluating the efficacy of rehabilitation for patients with GBS. Results. The research strategy identified 606 results. After excluding duplicates (n = 230), and after a thorough assessment, six studies were included. Every study showed positive effects of rehabilitation in patients with GBS. Two studies used GBS – Disability Score to evaluate rehabilitation efficacy, which had positive results (p &lt; 0.0001 and p &lt; 0.01). Another study found that supervised, individualized exercise was more efficient than unsupervised home exercise. There was also a study with groups of children with GBS, who had electromyographic biofeedback therapy, that showed positive dynamics (p &lt; 0.05). Another study assessed neuropathic pain and presented a reduction in pain after rehabilitation (p &lt; 0.05). Conclusion. Patients with GBS have achieved significant positive changes in mobility, cognitive function, and performance of daily tasks after rehabilitation treatment. Keywords: Guillain-Barre syndrome, rehabilitation, electrical stimulation, physical therapy, exercise.

Effect of combination of botulinum toxin and electromyographic biofeedback therapy on post-stroke patients with lower limb muscle spasticity

Purpose: To investigate the clinical effect of combined use of botulinum toxin type A and electromyographic biofeedback therapy (EMGBFT) on post-stroke patients with lower limb muscle spasticity.&#x0D; Methods: The data of 91 post-stroke patients with lower limb muscle spasticity who were admitted to Shanghai Seventh People’s Hospital (January 2020 -January 2021) were retrospectively analyzed, and they were divided into control group (COG, n = 45) and study group (STG, n = 46) based on the treatments given. All patients received conventional rehabilitation and training. Patients in COG were treated with EMGBFT, whereas those in STG received botulinum toxin type A as well as EMGBFT. The parameters determined in the two groups were degree of spasticity, lower limb motor function [3m-Timed Up and Go (3m - TUG) and 10m - Walk Test (10 m - WT)], active range of motion (AROM) of ankle dorsiflexion, ability of daily living (based on Barthel Index, BI), and adverse reactions before and after treatment.&#x0D; Results: The effectiveness of the treatments on spasticity was higher in STG than in COG (p &lt; 0.05). After treatment, the times taken for 3m-TUG and 10m-WT were significantly shorter in STG than in COG (p &lt; 0.05). The AROM of patients in both groups was expanded, but the expansion was significantly greater in STG than in COG (p &lt; 0.05).&#x0D; Conclusion: Combined therapy using botulinum toxin and EMGBFT effectively relieved lower limb muscle spasticity of post-stroke patients, and also improved their lower limb motion function and daily living ability. Thus, the combined therapy provided better management of lower limb spasticity. However, further clinical trials are required prior to its adoption in clinical practice.

Effect of Electromyographic Biofeedback Therapy on Muscle Strength Recovery in Children with Guillain-Barré Syndrome.

GBS, as an immune-mediated acute inflammatory peripheral neuropathy (Tan and Halpin et al.), with the characteristics of acute onset and rapid progression, is mainly manifested with damages in nerve root and peripheral nerve. The purpose of the study was to investigate the effect of electromyographic biofeedback therapy on muscle strength recovery in children with Guillain–Barré syndrome (GBS). A total of 62 GBS children patients admitted to our hospital from June 2014 to December 2018 were selected and divided into control group (n = 30) and experimental group (n = 32) according to the order of admission. The children patients in the control group received physical therapy combined with occupational therapy (PT + OT), while based on the treatment in the control group, the experimental group children patients were treated with electromyographic biofeedback therapy. After that, the recovery of nerve and muscle at different time points, muscle strength score, gross motor function measure (GMFM) score, and Barthel index (BI) score of the children patients before and after treatment were compared between the two groups. There were no significant differences in the recovery of nerve and muscle of the children patients between the two groups at T0 and T1 (P > 0.05), and the recovery of nerve and muscle of the children patients in the experimental group was significantly better than that in the control group at T2, T3, and T4 (P < 0.001); the muscle strength score, GMFM score, and BI score of the children patients in the experimental group were significantly better than those in the control group after treatment (P < 0.001). The application of electromyographic biofeedback therapy for the treatment of GBS can effectively relieve clinical symptoms, promote rapid recovery, and improve treatment efficacy in children patients, which is worthy of application and promotion.

Effects of Electromyographic Biofeedback Therapy Combined with Comprehensive Rehabilitation Training on Lower Limb Motor Function in Patients with Stroke Recovery

This article explores the effects of myoelectric biofeedback therapy association with rehabilitation training on LLMF in patients with stroke and hemiplegia. Sixty patients with stroke and hemiplegia were separated into the control group and the treatment group. The two groups were disposed neuromedicine drugs and rehabilitation training, while the treatment group also increased the training of the affected side's lower limb electromyography. The same therapist evaluated Fugl-Meyer score (FMA), M-B index (MBI), Berg Balance Scale (BBS), score before and 4 weeks after treatment, and performed statistical analysis. The results showed that the FMA scores, balance ability scores, daily living ability scores, and active range scores of the wrist and stepping joints of the upper and lower limbs after several weeks of treatment in the two groups were better than those in the group before treatment. The scores of the EMG biofeedback treatment group at several weeks were better than the control group of the same period, the difference was statistically significant. EMG Biofeedback Therapy Combined with Comprehensive Rehabilitation Training can effectively improve upper and lower extremity movement, balance function, daily life ability, dorsiflexion of the wrist and dorsiflexion of the step joints after stroke, and the effect is better than that of conventional rehabilitation therapy.

Reproducibility and reliability of performance indicators to evaluate the therapeutic effectiveness of biofeedback therapy after elbow surgery: An observational case series.

Electromyographic biofeedback (EMG-BF) therapy provides information on the state of contraction of the targeted muscles and relaxation of their antagonists, which can facilitate early active range of motion (RoM) after elbow surgery. Our aim in this study was to calculate the minimum detectable change (MDC) during EMG-BF therapy, initiated in the early postoperative period after elbow surgery.This study is an observational case series. EMG-BF of muscle contraction and relaxation was provided during active elbow flexion and extension exercises. Patients completed 3 sets of 10 trials each of flexion and extension over 4 weeks. The total range of flexion-extension motion and scores on the Japanese Society for Surgery of the Hand version of the disability of the arm, shoulder, and hand questionnaire and the Japanese version of the Patient-Rated Elbow Evaluation were obtained at baseline and weekly during the 4-week intervention period. A prediction formula was developed from the time-series data obtained during the intervention period, using the least-squares method. The estimated value was calculated by removing the slope from the prediction formula and adding the initial scores to residuals between the measured scores and predicted scores individually. Systematic error, MDC at the 95th percentile cutoff (MDC95), repeatability of the measures, and the change from the baseline to each time-point of intervention were assessed.The MDC95 was obtained for all 3 outcome measures and the range of values was as follows: RoM, 8.3° to 22.5°; Japanese version of the Patient-Rated Elbow Evaluation score, 17.6 to 30.6 points; and disability of the arm, shoulder, and hand questionnaire subscale: disability and symptoms score, 14.2 to 22.9 points.The efficacy of EMG-BF after elbow surgery was reflected in earlier initiation of elbow RoM after surgery and improvement in patient-reported upper limb function scores. The calculated MDC95 cut-offs could be used as reference values to assess the therapeutic effects of EMG-BF in individuals.

Relative Effectiveness of Electroacupuncture and Biofeedback in the Treatment of Neck and Upper Back Myofascial Pain: A Randomized Clinical Trial

ObjectiveTo determine the differences between clinical effects of electroacupuncture and biofeedback therapy in addition to conventional treatment in patients with cervical myofascial pain syndrome (MPS). DesignRandomized clinical trial. SettingPhysical medicine and rehabilitation clinic of a university hospital. ParticipantsFifty patients (N=50) aged 25-55 years of both sexes with chronic neck pain diagnosed with MPS (characterized by trigger points within taut bands) were randomly assigned to 2 equal groups of 25 individuals. InterventionsThe patients in electroacupuncture group were treated with standard acupuncture and concomitant electrical stimulation; those in biofeedback group received visual electromyography biofeedback therapy for muscle activity and relaxation. Both groups received the intervention 2 times a week for a total of 6 sessions. Basic exercise training and medicines were administered for all the patients. Main Outcome MeasuresPain severity based on the visual analog scale (VAS), functional status using Neck Disability Index (NDI), cervical range of motion (ROM) using and inclinometer, and pressure pain threshold (PPT) using an algometer were evaluated before and at 3 and 12 weeks after the treatment. Primary outcome was defined as 20% reduction in the 3-month neck pain and dysfunction compared to baseline, assessed through the NDI. ResultsFifty patients (39 women, 11 men) with a mean age (years) ± SD of 39.0±5.5 and neck pain duration (weeks) of 6.0±2.2 were analyzed. All parameters, except for PPT of the lower trapezius and paravertebral muscles were improved significantly in both groups, while baseline values were controlled. The primary outcome was achieved more significantly in the acupuncture group than in the biofeedback group: 20 (80.0%) vs 10 (40.0%); rate ratio=2 with 95% confidence interval (CI), 1.19-3.36; number needed to treat (NNT)=2.5 with 95% CI, 1.54-6.58. Advantages of acupuncture over biofeedback were observed according to values obtained from the NDI, VAS, extension and left lateral-bending ROM, and PPT on the left upper trapezius after the last session of intervention until 3 months (P<.05). ConclusionsBoth electroacupuncture and biofeedback therapies were found to be effective in management of MPS when integrated with conventional treatment. However, intergroup differences showed priority of acupuncture in some parameters vs biofeedback. Thus, electroacupuncture seems to be a better complementary modality for treatment of MPS in the neck and upper back area.

Effect of Electromyographic Biofeedback Therapy on Ulnar Nerve Injury in Different Degrees

Effect of Electromyographic Biofeedback Therapy on Ulnar Nerve Injury in Different Degrees

The effectiveness and safety of electromyography biofeedback therapy for motor dysfunction of children with cerebral palsy: A protocol for systematic review and meta-analysis.

To investigate the effectiveness and safety of electromyography (EMG) biofeedback therapy in improving motor dysfunction among children with cerebral palsy (CP). The following databases will be searched: PubMed, EMBASE, ScienceDirect, the Cochrane Library, China National Knowledge infrastructure (CNKI), Technology Periodical Database (VIP), WanFang Data and China Biology Medicine (CBM) from inception to June 2019. All relevant randomized controlled trials (RCTs) utilizing EMG biofeedback therapy for CP will be included. The main outcome is the Gross Motor Function Measure (GMFM). Additional outcomes such as the Modified Ashworth Scale (MAS), Integral Electromyogram (iEMG), Composite Spasticity Scale (CSS), passive range of motion (PROM) or other related outcomes will be included, adverse effects of EMG biofeedback therapy and comparators will also be included. Two reviewers will screen studies, extract data and assess quality independently. Review Manager 5.3 will be used to assess the risk of bias, data synthesis, and subgroup analysis. This systematic review does not require formal ethical approval because all data will be analyzed anonymously. Results will provide a general overview and evidence concerning the effectiveness and safety of EMG biofeedback therapy for children with CP. The findings of this systematic review will be disseminated through peer-reviewed publications or conference presentations.

Effects of electromyographic biofeedback as an adjunctive therapy in the treatment of swallowing disorders: a systematic review of the literature

To describe the primary effects of electromyographic biofeedback therapy on swallowing via a systematic review. A blind search was carried out by two researchers in the PubMed and Bireme platforms and in the Medline, Lilacs, SciELO, PsycINFO, CINAHL, and Web of Science databases, and the journal articles identified therein were evaluated for inclusion in the study. Original articles associated with the theme were selected with no population-, region-, or language-associated limits. A protocol was created for this study with the following points: author, year, place, number and characteristics of participants, activities evaluated, instruments used, and main results. The PEDro scale was used to analyze the quality of the studies. Among the 686 articles identified in the combined searches, 566 were duplicates. A total of 65 articles were discarded after the title and abstract were read, and a further 29 articles were discarded after the full text was read, yielding a total of six articles for inclusion. In summary, the results lead us to believe that positive effects on the laryngeal lifting capacity, improved swallowing functions, and increased excursion and maximal elevation of the hyoid bone, may be directly related to this method of therapy. Adjunctive therapeutic protocols with biofeedback electromyography exert positive effects on swallowing function.

Clinical effect evaluation and experience of MOTOmed virtual scene training combined with electromyographic biofeedback therapy in the treatment of spastic cerebral palsy

Substantial evidence from clinical reports has established that most cerebral palsy (CP) patients benefit from a comprehensive rehabilitation exercise training programme. Such advances are enhanced when Motomed virtual scene training combined with electromyographic biofeedback therapy in the treatment of spastic cerebral palsy. However, little information exists regarding these effects. Forty-eight children with spastic cerebral palsy were collected from 2014 to 2016 in children's rehabilitation department of Huai’an maternal and child health hospital. Among them, 25 cases were treated with MOTOmed virtual scene training combined with electromyographic biofeedback therapy, and 23 cases with single electromyographic biofeedback therapy. Before and after treatment, the Gross Motor Function Measure-88 (GMFM-88) was used to evaluate the gross motor function of all children, and Activities of Daily Living Scale (ADL) was used to evaluate and observe the activities of daily living of children. The scores of GMFM and ADL in the treatment and control groups were significantly higher than those before treatment ( P < 0.05). Before treatment, GMFM and ADL scores in the treatment groups were significantly higher than those in the control groups ( P < 0.05). MOTOmed virtual scene training combined with electromyographic biofeedback therapy can effectively improve the gross motor function and activities of daily living of children with spastic cerebral palsy, which is obviously superior to electromyographic biofeedback therapy alone.

Treatment of Stroke Patients with Shoulder-wrist Syndrome by Acupoint Catgut Embedding and Surface Electromyogram Biofeedback Therapy

To observe the clinical effectiveness of acupoint catgut embedding and surface electromyogram biofeedback therapy (sEMGBF) in the treatment of stroke patients complicated with shoulder-hand syndrome (SHS). A total of 90 stroke patients with SHS were randomly divided into acupoint catgut embedment (ACE), sEMGBF and ACE+sEMGBF (combined treatment) groups (n=30 cases/group). The catgut embedment was performed at Jianliao (LI 14), Jianyu (LI 15), Quchi (LI 11), Waiguan (TE 5) on the affected side, once every 3 weeks, twice altogether. The electromyographic biofeedback therapy (30-50 Hz, pulse duration 200 µs, 6 s-on and 10 s-off, appropriate strength) was applied to the skin area co-vering the deltoid muscle, flexor muscle of wrist and wrist extensor for 20 min, once per day, 5 times/week, for 6 weeks. The total effective rate was assessed by using Liao's and Zhu's methods (1996), the pain severity assessed using visual analogue scale (VAS), and Fugl-Meyer assessment (FMA, 66-points) scale and the patients' activities of daily living function (ADL, 100-points) were also scored. Before treatment, the VAS, FMA and ADL points of the three groups were not significantly different (P>0.05). After the treatment, the total effective rate (93.33%), FMA and ADL scores of the combined treatment group were significantly higher than those of the ACE and sEMGBF groups (P<0.05), while the VAS score of the combined treatment group was significantly lower than those of the ACE and sEMGBF groups (P<0.05). The total effective rates, FMA and ADL scores of the ACE and sEMGBF groups were comparable (P>0.05). The VAS score of the ACE group was markedly lower than that of the sEMGBF group (P<0.05). The combined administration of ACE and sEMGBF has a better therapeutic effect for stroke patients complicated with SHS relevant to simple ACE and simple sEMGBF therapy in improving the upper limb function, relieving pain, and enhancing the daily life quality.

Application effect of swallowing training and ice stimulation combined with electromyography biofeedback therapy in stroke patients with swallowing and coughing

Objective To investigate the application effect of swallowing training and ice stimulation combined with electromyography biofeedback therapy in stroke patients with swallowing and coughing. Methods Seventy-nine stroke swallowing and coughing patients treated were collected and were randomly divided into two groups (39 cases in control group, 40 cases in observation group) according to the digital table.The control group was treated with normal swallowing training, while the observation group was treated with ice stimulation combined with electromyography biofeedback therapy.The clinical intervention effect and the VFSS results before and after the intervention were observed and compared.The complications of the two groups were statistically analyzed. Results The total effective rate of the observation group [90.00%(36/40)] was higher than that of the control group[71.79%(28/39), χ2=4.255, P=0.039]. After eight-week intervention, the VFSS score of the observation group was higher than that of the control group(t=12.173, P=0.000); and the incidence rate of complications of the observation group[7.50%(3/40)] was lower than that of the control group [25.64%(10/39), χ2=4.727, P=0.030]. Conclusion Swallowing training and ice stimulation combined with electromyography biofeedback therapy can significantly improve the swallowing function of stroke patients with swallowing and coughing, and it is safe. Key words: Stroke; Deglutition disorders; Ice stimulation; Electromyography biofeedback

Therapeutic efficacy of neuromuscular electrical stimulation and electromyographic biofeedback on Alzheimer's disease patients with dysphagia.

To study the therapeutic effect of neuromuscular electrical stimulation and electromyographic biofeedback (EMG-biofeedback) therapy in improving swallowing function of Alzheimer's disease patients with dysphagia.A series of 103 Alzheimer's disease patients with dysphagia were divided into 2 groups, among which the control group (n = 50) received swallowing function training and the treatment group (n = 53) received neuromuscular electrical stimulation plus EMG-biofeedback therapy. The mini-mental state scale score was performed in all patients along the treatment period. Twelve weeks after the treatment, the swallowing function was assessed by the water swallow test. The nutritional status was evaluated by Mini Nutritional Assessment (MNA) as well as the levels of hemoglobin and serum albumin. The frequency and course of aspiration pneumonia were also recorded.No significant difference on mini-mental state scale score was noted between 2 groups. More improvement of swallowing function, better nutritional status, and less frequency and shorter course of aspiration pneumonia were presented in treatment group when compared with the control group.Neuromuscular electrical stimulation and EMG-biofeedback treatment can improve swallowing function in patients with Alzheimer's disease and significantly reduce the incidence of adverse outcomes. Thus, they should be promoted in clinical practice.

Development of a low-cost EMG biofeedback device kit as an educational tool for physical therapy students

[Purpose] Electromyography biofeedback therapy is applied to various diseases during physical therapy for motor learning. Our aim was to develop a low-cost electromyography biofeedback device kit that students could build by themselves in class and to evaluate whether this kit was an adequate educational tool for physical therapy students. [Subjects and Methods] This study included 34 volunteers from a 3 year physical therapy vocational school and a 4 year university course. All students were tasked with: 1) completing a pre-questionnaire; 2) attending basic lectures on electromyography biofeedback therapy and how to build the device; 3) building the device; and 4) completing a post-questionnaire. [Results] Mean time required to build the device was 50.8 ± 34.1 minutes for the vocational course students and 27.4 ± 8.8 minutes for university students. For both groups, there was a significant increase in the number of students stating “have an interest in,” “be involved with,” and “have knowledge of electromyography biofeedback” when pre- and post-questionnaires were compared. In the post questionnaire, the frequency of the “knowledge increased” response was higher. [Conclusion] Physical therapy students can easily build our new device in a classroom, and this kit is a useful educational tool to motivate learning in electromyography biofeedback.

The efficacy of post-operative devices following knee arthroscopic surgery: a systematic review.

There is a wide array of device modalities available for post-operative treatment following arthroscopic knee surgery; however, it remains unclear which types and duration of modality are the most effective. This systematic review aimed to investigate the efficacy of device modalities used following arthroscopic knee surgery. A systematic search of the literature was performed on: PubMed; Scopus; MEDLINE; EMBASE; PEDro; SportDiscus; and CINAHL databases (1995-2015) for clinical trials using device modalities following arthroscopic knee surgery: cryotherapy, continuous passive motion (CPM), neuromuscular electrical stimulation (NMES), surface electromyographic (sEMG) biofeedback and shockwave therapy (ESWT). Only level 1 and 2 studies were included and the methodological quality of studies was evaluated using Physiotherapy Evidence Database (PEDro) scores. Outcome measures included: muscle strength, range of motion, swelling, blood loss, pain relief, narcotic use, knee function evaluation and scores, patient satisfaction and length of hospital stay. Twenty-five studies were included in this systematic review, nineteen of which found a significant difference in outcomes. For alleviating pain and decreasing narcotic consumption following arthroscopic knee surgery, cryocompression devices are more effective than traditional icing alone, though not more than compression alone. CPM does not affect post-operative outcomes. sEMG biofeedback and NMES improve quadriceps strength and overall knee functional outcomes following knee surgery. There is limited evidence regarding the effects of ESWT. Cryotherapy, NMES and sEMG are recommended for inclusion into rehabilitation protocols following arthroscopic knee surgery to assist with pain relief, recovery of muscle strength and knee function, which are all essential to accelerate recovery. CPM is not warranted in post-operative protocols following arthroscopic knee surgery because of its limited effectiveness in returning knee range of motion, and additional studies are required to investigate the effects of ESWT. II.

Muscles and their role in episodic tension-type headache: implications for treatment.

Tension-type headache (TTH) imposes a heavy burden on the global population but remains incompletely understood and poorly managed. Here, we review current knowledge of peripheral factors involved in the mechanism of TTH and make recommendations for the treatment of episodic TTH based on these. Peripheral activation or sensitization of myofascial nociceptors is most probably involved in the development of muscle pain and the acute episode of TTH. Repetitive episodes of muscle pain may sensitize the central nervous system resulting in progression of TTH to the chronic form. Thus, muscular factors may be responsible not only for the acute headache episode but also for chronification of the disorder. Simple analgesics and non-steroidal anti-inflammatory drugs are the mainstays of management of individual headache episodes. Ibuprofen 400 mg and aspirin 1000 mg are recommended as drugs of first choice based on treatment effect, safety profile and costs. Non-pharmacological therapies include electromyographic biofeedback, physiotherapy and muscle relaxation therapy. Future studies should aim to identify the triggers of peripheral nociception and how to avoid peripheral and central sensitization. There is a need for more effective, faster acting drugs for acute TTH. Muscular factors play an important role in episodic TTH. Ibuprofen 400 mg and aspirin 1000 mg are recommended as drugs of first choice.

The effects of electromyographic biofeedback in the treatment of dysphagia after stroke

Objective To investigate the efficacy of electromyographic biofeedback therapy (EMGBFT) in treating dysphagia after stroke.Methods Patients diagnosed with dysphagia after stroke were recruited and randomly divided into a control group (n =22),an electrostimulation group (ES,n =25) and an EMGBFT group (n =23).The control group received conventional treatment,while the patients in the other groups additionally received Vitalstim ES or EMGBFT 5 times per week for 3 weeks.Before and after the trial,deglutition function was evaluated through surface electromyography (sEMG) and using a standardized swallowing assessment (SSA).Results After 3 weeks of treatment,the mean sEMG amplitude,deglutition duration and SSA score and improved significantly in comparison to the baseline in all three groups.All were also significantly better in the two treatment groups than in the control group.Importantly,the mean sEMG amplitude,deglutition duration and SSA score were all significantly better in the EMGBFT group than in the ES group.Conclusion EMGBFT can promote better deglutition among patients with dysphagia after stroke more effectively than ES or conventional treatment. Key words: Stroke ; Dysphagia ; Electromyography, Biofeedback