Electromyographic Biofeedback Treatment Research Articles

Clinical research on the effects of Chinese herb fumigation and washing combined with electromyographic biofeedback on stroke patients with muscle cramp on limbs

Objective We tried to observe the effects of Chinese herb fumigation and washing combined with electromyographic biofeedback on stroke patients with muscle cramp on limbs. Methods 84 patients who had muscle cramp on limbs were selected and divided into two groups randomly, namely the intervention group and the control group and both groups had 42 stroke patients. The intervention group was treated with routine treatment, Chinese herbal fumigation and washing and electromyographic biofeedback treatment. The control group received only routine treatment and electromyographic biofeedback treatment. We had compared and analyzed the Ashworth Spasticity Scale and the Daily Life Ability Score (Barthel index) of the two groups at the time of the pre therapy, two weeks after the treatment and at the end of the treatment(after four weeks), respectively. Results There were no significant differences between the two groups in Barthel index, however, there were significant differences in Ashworth Spasticity Scale scores between the two groups four weeks after treatment, t=-3.84, P<0.05. Conclusions The effect of Chinese herb fumigation and washing combining with the electromyo-graphic biofeedback treatment is better than usage of the electromyographic biofeedback treatment alone on stroke patients with muscle cramp on limbs. Key words: Chinese herb fumigation and washing; Electromyographic biofeedback treatment; Stroke; Muscle cramp

Assessment of biofeedback rehabilitation in post-stroke patients combining fMRI and gait analysis: a case study

BackgroundThe ability to walk independently is a primary goal for rehabilitation after stroke. Gait analysis provides a great amount of valuable information, while functional magnetic resonance imaging (fMRI) offers a powerful approach to define networks involved in motor control. The present study reports a new methodology based on both fMRI and gait analysis outcomes in order to investigate the ability of fMRI to reflect the phases of motor learning before/after electromyographic biofeedback treatment: the preliminary fMRI results of a post stroke subject’s brain activation, during passive and active ankle dorsal/plantarflexion, before and after biofeedback (BFB) rehabilitation are reported and their correlation with gait analysis data investigated.MethodsA control subject and a post-stroke patient with chronic hemiparesis were studied. Functional magnetic resonance images were acquired during a block-design protocol on both subjects while performing passive and active ankle dorsal/plantarflexion. fMRI and gait analysis were assessed on the patient before and after electromyographic biofeedback rehabilitation treatment during gait activities. Lower limb three-dimensional kinematics, kinetics and surface electromyography were evaluated. Correlation between fMRI and gait analysis categorical variables was assessed: agreement/disagreement was assigned to each variable if the value was in/outside the normative range (gait analysis), or for presence of normal/diffuse/no activation of motor area (fMRI).ResultsAltered fMRI activity was found on the post-stroke patient before biofeedback rehabilitation with respect to the control one. Meanwhile the patient showed a diffuse, but more limited brain activation after treatment (less voxels). The post-stroke gait data showed a trend towards the normal range: speed, stride length, ankle power, and ankle positive work increased. Preliminary correlation analysis revealed that consistent changes were observed both for the fMRI data, and the gait analysis data after treatment (R > 0.89): this could be related to the possible effects BFB might have on the central as well as on the peripheral nervous system.ConclusionsOur findings showed that this methodology allows evaluation of the relationship between alterations in gait and brain activation of a post-stroke patient. Such methodology, if applied on a larger sample subjects, could provide information about the specific motor area involved in a rehabilitation treatment.

Increased EMG response following electromyographic biofeedback treatment of rectus femoris muscle after spinal cord injury

Objective To study increases in electromyographic (EMG) response from the right and left rectus femoris muscles of individuals with long-term cervical spinal cord injuries after EMG biofeedback treatment. Design Repeated measure trials compared EMG responses before and after biofeedback treatment in patients with spinal cord injuries. Main outcome measures The Neuroeducator was used to analyse and provide feedback of the EMG signal and to measure EMG response. Setting Department of Traumatic Orthopaedics, School of Medicine, University of São Paulo, Brazil. Participants Twenty subjects (three men and 17 women), between 21 and 49 years of age, with incomplete spinal cord injury at level C6 or higher (range C2 to C6). Of these subjects, 10 received their spinal cord injuries from motor vehicle accidents, one from a gunshot, five from diving, three from falls and one from spinal disc herniation. Results Significant differences were found in the EMG response of the right rectus femoris muscle between pre-initial (T1), post-initial (T2) and additional (T3) biofeedback treatment with the subjects in a sitting position [mean (standard deviation) T1: 26 μV (29); T2: 67 μV (50); T3: 77 μV (62)]. The mean differences and 95% confidence intervals for these comparisons were as follows: T1 to T2, −40.7 (−53.1 to −29.4); T2 to T3, −9.6 (−26.1 to 2.3). Similar differences were found for the left leg in a sitting position and for both legs in the sit-to-stand condition. Conclusions The EMG responses obtained in this study showed that treatment involving EMG biofeedback significantly increased voluntary EMG responses from right and left rectus femoris muscles in individuals with spinal cord injuries.

The effect of electromyographic biofeedback on visceralgia hypersensitivity in patients with refractory irritable bowel syndrome

Objective To study the effect of electromyographie biofeedback on visceralgia hypersensitivity in patients with refractory irritable bowel syndrome (IBS) and the relationship between psychological factors and vis-ceral hypersensitivity. Methods Sixty patients with refractory IBS were enrolled in this study and received electro-myographic biofeedback treatment for 4 weeks. The threshold of visceralgia, and scores on the Hamilton anxiety rating scale (HAMA) and the Hamilton depression rating scale (HAMD) were evaluated before and after treatment. Re-suits Compared with the baseline values, the threshold of visceralgia increased significantly during treatment(P≤ 0101) and the total scores on both the HAMA and HAMD had declined significantly (P≤0.01) by the end of 4, weeks of treatment. The evolution of the index of the threshold of visceralgia was negatively correlated with the evolu-tion of both the HAMA and HAMD scores (r = -0.543, P≤0.01; r = -0.728,P≤0.01). Conclusion Elec-tromyographic biofeedback treatment can elevate the threshold of visceralgia hypersensitivity in patients with refractory IBS. Anxiety and depression might contribute to visceralgia hypersensitivity in IBS. Key words: Electromyographic biofeedback ; Irritable bowel syndrome ; Psychological factors ; Visceral sensitivity ;

Electromyographic biofeedback–controlled exercise versus conservative care for patellofemoral pain syndrome

Dursun N, Dursun E, Kiliç Z. Electromyographic biofeedback–controlled exercise versus conservative care for patellofemoral pain syndrome. Arch Phys Med Rehabil 2001;82:1692-5. Objective: To determine the effects of electromyographic biofeedback treatment in patients with patellofemoral pain syndrome. Design: Randomized controlled trial. Setting: A physical medicine and rehabilitation department in a research hospital of a university referral center. Patients: Sixty patients with patellofemoral pain syndrome. Patients were randomly placed into 2 groups: biofeedback group (n = 30) and a control group (n = 30). Intervention: The biofeedback group received electromyographic biofeedback training and a conventional exercise program, whereas the control group received a conventional exercise program only. Main Outcome Measures: Maximum and mean contraction values of the vastus medialis and the vastus lateralis muscles were assessed with the biofeedback device. Pain and functional status of the patients were measured by a visual analog scale (VAS) and the Functional Index Questionnaire (FIQ), respectively. Results: Contraction values improved significantly at the end of the first month, compared with the pretreatment values in both groups. Mean contraction values in the biofeedback group of the vastus medialis muscles in all 3 monthly measurements, and the vastus lateralis muscles at the end of the first month, were significantly higher than those of the control group. Significant improvements were shown for both the VAS and the FIQ in both groups. Monthly follow-ups showed no VAS and FIQ differences between the groups. Conclusion: Electromyographic biofeedback treatment did not result in further clinical improvement when compared with a conventional exercise program in patients with patellofemoral pain syndrome. © 2001 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

Age comparisons in acquiring biofeedback control and success in reducing headache pain.

This article presents a review and archival analysis to assess age differences in acquiring biofeedback control and success in treating recurrent headache by using data from 56 studies with either adult (total N = 503) or child (total N = 98) subjects. All studies focused on treating headache with temperature biofeedback (TBF) or electromyographic (EMG) biofeedback. To standardize the varied measures across studies, we calculated each study's percent change scores for biofeedback performance and headache activity. All headache activity scores included assessments of pain intensity. We then calculated subject-weighted means of percent change for biofeedback performance and for headache activity by summing the products of each relevant percent change score and N and then dividing by the total number of subjects contributing to those sums. Results showed that both children and adults reported substantial improvements in headache activity with TBF and EMG biofeedback treatment (Ms ranged from 34% to 81%), but children showed significantly greater improvement than adults. No age differences were found in the acquisition of biofeedback control. Further analyses revealed two additional findings. First, biofeedback control and headache improvement were strongly correlated. Second, headache activity continued to decrease in the weeks following treatment, and this decrease was significantly greater for children than adults.

Rehabilitation of walking with electromyographic biofeedback in foot-drop after stroke.

Alterations of gait cycle and foot-drop on the paretic limb are characteristic of stroke patients. Electromyographic biofeedback treatment has been used in rehabilitation of walking, but results are controversial. We performed gait analysis to evaluate the efficacy of electromyographic biofeedback compared with physical therapy. Sixteen patients with ischemic stroke were enrolled in the study. The experimental group (4 men, 4 women) received electromyographic biofeedback treatment together with physical therapy. The control group (5 men, 3 women) was treated with physical therapy only. Clinical and functional evaluations before and after treatment were performed using Canadian Neurological, Adams, Ashworth, Basmajian, and Barthel Index scales. Computerized gait analysis was performed in all patients. Electromyographic biofeedback patients showed significantly increased scores on the Adams scale (P < .05) and Basmajian scale (P < .01). Gait analysis in this group showed a recovery of foot-drop in the swing phase (P < .02) after training. Our data confirm that the electromyographic biofeedback technique increases muscle strength and improves recovery of functional locomotion in patients with hemiparesis and foot-drop after cerebral ischemia.

EMG biofeedback treatment of torticollis: A controlled outcome study

Successful treatment of torticollis with electromyographic (EMG) biofeedback has been reported in a number of single case and single group studies. The present investigation represents the first controlled outcome study. Twelve torticollis patients were randomly assigned to EMG biofeedback or relaxation training and graded neck exercises (RGP). The procedure involved three sessions of baseline assessment, 15 sessions of EMG BF or RGP, 6 sessions of EMG BF or RGP plus home-management, 6 sessions of home-management alone, and follow-up 3 months after the end of treatment. A variety of outcome measures were used including physiological (EMG from the two sternocleidomastoid muscles, skin conductance level), behavioral (angle of head deviation, range of movement of the head), and self-report (depression, functional disability, body concept), therapist and "significant other" reports and independent observer assessment of videos. In both groups, neck muscle activity was reduced from pre- to posttreatment. This reduction was greater in the EMG biofeedback group. There was evidence of feedback-specific neck muscle relaxation in the EMG biofeedback group. Therefore, the outcome was not due to nonspecific factors and could be attributed to feedback-specific effects. Changes in skin conductance level showed that neck muscle relaxation was not simply mediated by a general reduction of "arousal." Significant improvements of extent of head deviation, and range of movement of the head, as well as reductions of depression were present, which were not different in the two groups. At the end of treatment, no patient was asymptomatic. Any therapeutic benefit was generally maintained at follow-up. The results and the procedural simplicity of RGP make the issue of cost-efficacy of EMG biofeedback a pertinent one. Further controlled outcome studies of EMG biofeedback treatment of torticollis with larger samples are required.