Electromyographic Biofeedback Research Articles

Improvements in motor control are associated with improved quality of life following an at-home muscle biofeedback program for chronic stroke

IntroductionChronic stroke survivors with severe arm impairment have limited options for effective rehabilitation. High intensity, repetitive task practice (RTP) is known to improve upper limb function among stroke survivors who have some volitional muscle activation. However, clients without volitional movement of their arm are ineligible for RTP-based interventions and require hands-on facilitation from a clinician or robotic therapy to simulate task practice. Such approaches can be expensive, burdensome, and have marginal effects. Alternatively, supervised at-home telerehabilitation using muscle biofeedback may provide a more accessible, affordable, and effective rehabilitation option for stroke survivors with severe arm impairment, and could potentially help people with severe stroke regain enough volitional activation to be eligible for RTP-types of therapies. Feedback of muscle activity via electromyography (EMG) has been previously used with clients who have minimal or no movement to improve functional performance. Specifically, training to reduce unintended co-contractions of the impaired hand using EMG biofeedback may modestly improve motor control in people with limited movement. Importantly, these modest and covert functional changes may influence the perceived impact of stroke-related disability in daily life. In this manuscript, we examine whether physical changes following use of a portable EMG biofeedback system (Tele-REINVENT) for severe upper limb hemiparesis also relate to perceived quality of life improvements. Secondarily, we examined the effects of Tele-REINVENT, which uses EMG to quantify antagonistic muscle activity during movement attempt trials and transform individuated action into computer game control, on several different domains of stroke recovery.MethodsFor this pilot study, nine stroke survivors (age = 37-73 years) with chronic impairment (Fugl-Meyer = 14-40/66) completed 30 1-hour sessions of home-based training, consisting of six weeks of gaming that reinforced wrist extensor muscle activity while attenuating coactivation of flexor muscles. To assess motor control and performance, we measured changes in active wrist ranges of motion, the Fugl-Meyer Assessment, and Action Research Arm Test. We also collected an EMG-based test of muscle control to examine more subtle changes. To examine changes in perceived quality of life, we utilized the Stroke Impact Scale along with participant feedback.ResultsResults from our pilot data suggest that 30 sessions of remote training can induce modest changes on clinical and functional assessments, showing a statistically significant improvement of active wrist ranges of motion at the group level, changes that could allow some people with severe stroke to be eligible for other therapeutic approaches, such as RTP. Additionally, changes in motor control were correlated with the perceived impact of stroke on participation and impairment after training. We also report changes in corticomuscular coherence, which showed a laterality change from the ipsilesional motor cortex towards the contralesional hemisphere during wrist extension attempts. Finally, all participants showed high adherence to the protocol and reported enjoying using the system.ConclusionOverall, Tele-REINVENT represents a promising telerehabilitation intervention that might improve sensorimotor outcomes in severe chronic stroke, and that improving sensorimotor abilities even modestly may improve quality of life. We propose that Tele-REINVENT may be used as a precursor to help participants gain enough active movement to participate other occupational therapy interventions, such as RTP. Future work is needed to examine if home-based telerehabilitation to provide feedback of individuated muscle activity could increase meaningful rehabilitation accessibility and outcomes for underserved populations.

Surface electromyography-based biofeedback can facilitate recovery from total knee arthroplasty.

Knee osteoarthritis is among the most prevalent chronic diseases. Total knee arthroplasty is a common solution that effectively addresses the continued structural degeneration of the articular cartilage. However, effective physical therapy is critical for recovery. Despite participating in physical therapy, many patients fail to recover. This study investigated the potential efficacy of a behaviorally informed approach to surface electromyographic biofeedback following total knee arthroplasty relative to the clinical standard, neuromuscular electrical stimulation. The surface electromyographic biofeedback procedure incorporated improved techniques for establishing a baseline and individualized and adjusting criteria for feedback. The findings suggest some advantages for surface electromyographic biofeedback over neuromuscular electrical stimulation in quadriceps strength, range of motion, functional recovery, and quality of life. Behaviorally informed surface electromyographic biofeedback holds promise for total knee arthroplasty recovery and these data suggest considerable room for collaboration between behavior analysts and physical therapists.

Transforming Rehabilitation for Scapular Dyskinesia: The role of Modified Robbery Exercises in enhancing Muscle Function, reducing Disability, and improving Quality of Life

Background: Scapular dyskinesia affects shoulder function, with significant implications for individuals, especially athletes. Rehabilitation approaches, including modified robbery exercises, aim to address this by improving scapular kinematics and muscle function. This study evaluates the effectiveness of modified robbery exercises supplemented with electromyography (EMG) biofeedback on muscle activation patterns and functional outcomes in individuals with scapular dyskinesia. Methods: A randomized controlled trial was conducted with 40 participants (20 in the control group receiving modified robbery exercises and ergonomic training, and 20 in the experimental group receiving modified robbery exercises with EMG biofeedback). Both interventions lasted 6 weeks, with sessions three times per week. Outcome measures included pain levels (Visual Analog Scale), muscle activation (EMG), functional disability (DASH questionnaire), and health-related quality of life (EQ-5D index and VAS). Independent samples t-tests were used to compare baseline and post-intervention differences between groups. Results: Post-intervention, the experimental group demonstrated significantly greater improvements in muscle activation for the Serratus Anterior, Upper Trapezius, and Lower Trapezius (p<0.001 for SA), indicating the benefit of EMG biofeedback. Both groups experienced pain reduction and functional improvements; however, the experimental group showed a more pronounced decrease in DASH scores (p=0.002) and a notable improvement in EQ-5D Index scores (p=0.008), pointing to enhanced functional outcomes and quality of life. Conclusions: Modified robbery exercises with EMG biofeedback are more effective than traditional exercises alone in improving muscle activation, reducing functional disability, and enhancing the quality of life in individuals with scapular dyskinesia. This study supports the integration of EMG biofeedback into rehabilitation programs for scapular dyskinesia, offering a promising approach for clinicians aiming to optimize recovery outcomes.

Favorable Clinical Outcomes After Humeral Head Depressor Muscle Coactivation Training With EMG for Patients With Arthroscopic Rotator Cuff Repair: A Randomized Controlled Trial.

The coactivation (Co-A) of shoulder muscles that contribute to humeral head depression can lead to mechanical unloading of the subacromial structures during abduction and thus can be beneficial for patients with arthroscopic rotator cuff repair (ARCR). The present study aims to examine the effectiveness of humeral head depressor muscle Co-A (DM-Co-A) training on clinical outcomes in a sample of patients with ARCR. We hypothesized that DM-Co-A training with medioinferior vector during glenohumeral exercises can improve clinical results in the rehabilitation of ARCR. Randomized controlled single-blind study. Level 1B. A total of 27 patients who underwent ARCR after a medium-sized rotator cuff tear and completed their Phase 1 training with ≥80% compliance were included. Together with 14 weeks of conservative treatment (6 weeks of Phase 2 training and 8 weeks of Phase 3 training), synchronized "DM-Co-A Training" was applied to the treatment group with an electromyography (EMG) biofeedback (EMG-BF) device. Patients in the treatment group were asked to voluntarily activate the humeral head depressor muscles guided by visual and auditory feedback of the EMG-BF device during the Phase 2 and Phase 3 conservative treatment exercises performed by the control group. Demographic characteristics of the participants were recorded. Visual analog scale and universal goniometer were used to assess pre- and posttreatment pain severity and joint range of motion, respectively. The Disabilities of Arm, Shoulder and Hand Questionnaire, Revised Oxford Shoulder Score, Modified Constant-Murley Shoulder Score, and the Western-Ontario Rotator Cuff Index were used to assess functionality. There was a clinically meaningful improvement in pain severity, active ROM excluding internal rotation, and functionality in the treatment group compared with the control group (P < 0.05). A 14-week duration DM-Co-A with EMG may be beneficial in the postoperative rehabilitation of patients after ARCR.

Research progress in spasmodic torticollis rehabilitation treatment.

Spasmodic torticollis (ST) is a focal dystonia that affects adults, causing limited muscle control and impacting daily activities and quality of life. The etiology and curative methods for ST remain unclear. Botulinum toxin is widely used as a first-line treatment, but long-term usage can result in reduced tolerance and adverse effects. Rehabilitation therapy, with its minimal side effects and low potential for harm, holds significant clinical value. This article explores the effectiveness of adjunctive therapies, including exercise therapy, transcranial magnetic stimulation, shockwave therapy, neuromuscular electrical stimulation, vibration therapy, electromyographic biofeedback, and acupuncture, in the treatment of ST. The aim is to provide clinicians with additional treatment options and to discuss the efficacy of rehabilitation therapy for ST.

Pre-Implementation Analysis of the Usability and Acceptability of a Poststroke Complex Telehealth Biofeedback Intervention.

Complex telehealth interventions can facilitate remote occupational therapy services and improve access for people living with chronic neurological conditions. Understanding the factors that influence the uptake of these technologies is important. To explore the fit between electromyography (EMG) biofeedback and telerehabilitation for stroke survivors, optimize EMG biofeedback interventions, and, more broadly, support other efforts to develop complex telerehabilitation interventions. Pre-implementation mixed-methods analysis of usability and acceptability data collected during a pilot and feasibility study. Community. Adult stroke survivors with hemiparesis (N = 11; M age = 54 yr). Game-based EMG biofeedback system for arm sensorimotor rehabilitation, delivered via telehealth. Post-Study System Usability Questionnaire, an extended Unified Theory of Acceptance and Use of Technology model questionnaire, and semistructured interview. We coded the interview data using questionnaire constructs. Participants used an EMG biofeedback intervention at home. Quantitative measures show high levels of perceived usability and acceptability, supported by qualitative findings describing specific facilitators and barriers. Pre-implementation studies can improve the design and relevance of complex telehealth interventions. One major conclusion from this study is the influence of therapy providers on acceptability and usability of complex telehealth interventions. Plain-Language Summary: This study contributes to an emerging body of literature that examines the use of complex telehealth interventions with survivors of neurological injury. The findings highlight the value and support the development and use of complex telehealth interventions, which have the potential to improve remote access to occupational therapy for clients living with chronic neurological conditions. Complex telehealth interventions can open doors for survivors of neurological injury who face barriers to accessing occupational therapy and would benefit from technology-enabled therapy at home.

Neuromuscular Rehabilitation of the Brachioradialis Muscle after Distal Radius Fracture in Two Professional Soccer Players Using Electromyographic Biofeedback

The use of electromyographic biofeedback (EMG-BF) in the rehabilitation of injuries has been widely referenced in the psychological literature. However, despite some pioneering work in the field of sports, its use in the rehabilitation of sports injuries has hardly been explored. A case of two professional soccer players who each suffered a distal radius fracture is presented here. Parallel to the rehabilitation plan established by medical services, an intervention strategy using EMG-BF was established. An EMG-BF intervention was performed on the brachioradialis muscle with the aim of improving the voluntary control of its electromyographic activity. The study protocol was registered with the identifier NCT05376072. An ABA design was used. In each session, a pre- and postline was recorded to determine the EMG gain acquired at each point of the session. After six sessions, the intervention was terminated. One more follow-up session was performed. The results obtained indicated the efficacy of the intervention; a statistically significant increase in muscle activity in the brachioradialis muscle was observed.

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].

Reduced center of mass acceleration during regular walking with electromyography biofeedback

BackgroundRegular walking in healthy adults is known to be kinematically stable, but it is unclear how to further kinematically stabilize regular walking. Electromyography biofeedback (EMG-BF) during walking improves walking ability in patients. However, the effect of EMG-BF on walking stability in healthy adults is unknown. Therefore, this study aimed to investigate whether EMG-BF enhances the stability of regular walking in healthy adults. Research questionDoes the EMG-BF enhance the stability of regular walking in healthy adults? MethodsAuditory biofeedback of single muscle activity was given to twelve participants during regular walking. The target muscles were the ankle plantar flexor, ankle dorsiflexor, and knee flexor. We compared the root mean square of the center of mass acceleration (RMS-CoMacc), which represents walking smoothness, between biofeedback conditions. ResultsWe found that EMG-BF during regular walking partially reduced the RMS-CoMacc (p = 0.01). In particular, biofeedback of the ankle plantar flexor muscle reduced the RMS-CoMacc in both the anteroposterior and vertical directions. In the mediolateral RMS-CoMacc, no significant difference was found (p = 0.24). SignificanceOur study is novel because it is the first study to reveal the impact of EMG-BF on the stability of walking among healthy adults. It identifies the key muscles for EMG-BF, potentially leading to the development of a more effective EMG-BF system in the rehabilitation. Especially, biofeedback of the ankle plantar flexor muscle could improve walking stability in both the anteroposterior and vertical directions. The effect of EMG-BF for reducing the RMS-CoMacc during regular walking might depend on the target muscles of biofeedback.

Effects of Electromyographic Biofeedback-Assisted Exercise on Functional Recovery and Quality of Life in Patients after Total Hip Arthroplasty: A Randomized Controlled Trial.

The goal of the trial was to examine the effects of adding electromyographic biofeedback (EMG-BF) to the conventional program of physiotherapy after total hip arthroplasty (THA) on functional recovery and quality of life. The trial was designed as a prospective, interventional, single-blinded randomized controlled study. Ninety patients were randomized into an experimental group (EG) (n = 45; mean age 63.9 ± 8.8) and control group (CG) (n = 45; mean age 63.9 ± 9). All patients received 21 days of physiotherapy which consisted of therapeutic exercise (land-based and aquatic), electrotherapy, and education. Electromyographic biofeedback was added to a portion of the land-based exercise in EG. The Hip Disability and Osteoarthritis Outcome Score (HOOS), Numeric Rating Scale (NRS), Short Form Health Survey-36 (SF-36), use of a walking aid, 30 s chair stand test (CST) as well as the Timed Up and Go (TUG) test were used for outcome measurement. A higher proportion of the participants in both groups did not need a walking aid after the intervention (p < 0.05). All participants improved their 30 s CST and TUG results (p < 0.001), as well as their NRS and HOOS scores (p < 0.05). No significant differences between the groups were found. There were no additional benefits from adding EMG-BF to the conventional physiotherapy protocol.

Efficacy of game training combined with surface electromyography biofeedback on post-stroke dysphagia

ObjectiveTo explore the efficacy of game training combined with surface electromyography biofeedback (sEMG-BF) in the treatment of dysphagia after early stroke. MethodsNinety patients with early post-stroke dysphagia (PSD), who were diagnosed and treated from March 2021 to December 2022, were divided randomly into a control group (30 cases), experimental group 1 (30 cases) and experimental group 2 (30 cases). The control group received routine swallowing rehabilitation and transcranial direct current stimulation. Experimental group 1 received sEMG-BF in conjunction with the care provided to the control group. Experimental group 2 received sEMG-BF and game training in addition to the care provided to the control group. Before and after treatment, all three patient groups were evaluated using the WADA water swallowing test, the Functional Oral Intake Scale (FOIS), sEMG and a tongue manometer test. ResultsBefore treatment, there was no significant difference (P > 0.05) among the three groups of patients in terms of WADA water swallowing rating, FOIS score, submandibular muscle sEMG peak, swallowing time limit and maximum tongue pressure. After treatment, all three groups exhibited improvements in these indices compared with those before treatment (P < 0.05). Experimental group 1 showed greater improvement than the control group (P < 0.05), and experimental group 2 exhibited greater improvement than experimental group 1 and the control group (P < 0.05). ConclusionGame training combined with sEMG-BF can significantly improve the swallowing function of patients with PSD.

Clinical study of pelvic floor electromyography Biofeedback combined with “four sacral needles” in the treatment of mild to moderate female stress Urinary incontinence

Clinical study of pelvic floor electromyography Biofeedback combined with “four sacral needles” in the treatment of mild to moderate female stress Urinary incontinence

Efficacy of Electromyographic Biofeedback in the Recovery of the Vastus Lateralis after Knee Injury: A Single-Group Case Study

Electromyographic biofeedback (EMG-BF) is a technique that can contribute to the improvement of muscle tone and control in the rehabilitation process after injury. The aim of this research was to determine the effectiveness of EMG-BF in increasing the electromyographic activity of the vastus lateralis after knee injury. The sample consisted of four individuals who had undergone surgery or rehabilitation to resolve either a partial meniscal tear or a patellar tendon strain. The intervention consisted of a program of ten sessions of EMG-BF work. Twelve trials were performed in each session, in which participants were instructed to target the muscle tension produced by the vastus lateralis of the uninjured hemilateral limb. Of the twelve trials in each session, the first three and the last three were performed without feedback, and the intermediate six with feedback. The recording of muscle activity was performed using CY-351/2 Mioback equipment, which allowed the amplitude of the electromyographic signal to be evaluated. The results indicated that the sample analyzed reached greater amplitude during the biofeedback trials, both for the maximum (Z = −13.43, p &lt; 0.001, Cohen’s d = 0.64, 95% CI (0.27, 1.01)) and mean (Z = −7.26, p &lt; 0.001, Cohen’s d = 0.24, 95% CI (−0.12, 0.60)) values. The amplitude also increased throughout the ten sessions, both for the maximum (Z = −3.06, p &lt; 0.01, Cohen’s d = 1.37, 95% CI (0.29, 2.45)) and mean (Z = −3.06, p &lt; 0.01, Cohen’s d = 1.20, 95% CI (0.34, 2.08)) values. Thus, the results highlight the efficacy of this technique in improving muscle activity, suggesting that it is a useful therapeutic procedure in injury recovery.

Surface Electromyography Biofeedback as an Adjuvant to Dysphagia Management: What It Is, What It Is Not, Why You Need It, and How to Get It

Purpose: Surface electromyography (sEMG) has been used by speech-language pathologists (SLPs) as a biofeedback tool to enhance the benefits of dysphagia rehabilitation since as early as 1976. Despite being noninvasive and user-friendly, sEMG biofeedback is not widely adopted by clinicians, potentially due to challenges such as insufficient knowledge about its appropriate clinical applications and the burden of acquiring this technology for a busy clinician. This article aims to support SLPs in utilizing sEMG as a simple biofeedback tool for dysphagia management by providing an overview of the physiological and technological underpinnings of sEMG as well as practical guidance on interpreting sEMG signal, optimizing signal quality, and documenting findings at the end of a session. Moreover, the article emphasizes the vital role clinicians have in promoting ongoing innovation in their field by advocating for modern solutions. It provides a framework and examples of how to request technologies in the clinic to foster an environment of continuous improvement in the service provided to patients. Conclusion: This article aims to equip clinicians with the knowledge and skills necessary to utilize sEMG technology effectively and help their patients achieve optimal outcomes in dysphagia management.

Effects of Biofeedback on Muscle Effort Reduction when Holding Positions with a Powered Upper Limb Exoskeleton

Exoskeletons have the potential to support daily activities by assisting the movement performance. Previous studies have shown that powered elbow exoskeletons can reduce muscle effort during continuous cyclic movement. However, natural movements have embedded stationary hold periods as well as transitions between postures. The human performance when using exoskeletons for more natural movements should be evaluated. In this study, we implemented visual and haptic electromyography (EMG) biofeedback to help people use an upper limb exoskeleton to perform a target position matching task. Participants (n=36) did not significantly reduce their muscle effort during hold periods when provided with biofeedback. Participants had difficulty relaxing their muscles at more flexed postures during hold periods, suggesting that they continued to provide effort instead of taking advantage of the device. To fully benefit from robotic exoskeletons, additional training and more advanced controllers might be needed.

Scapula-focused exercises with or without biofeedback increase corticospinal excitability in recreational overhead athletes with shoulder impingement.

Individuals with shoulder impingement syndrome (SIS) exhibit changed corticospinal excitability, scapular kinematics, and scapular muscle activation patterns. To restore the scapular kinematics and muscle activation patterns in individuals with SIS, treatment protocols usually include scapula-focused exercises, such as scapular orientation training and strength training. To investigate whether these two types of scapular exercise can reverse the changed corticospinal excitability of recreational overhead athletes with SIS. Randomized Controlled Clinical Trial. University laboratory. Forty-one recreational overhead athletes with SIS (n=20 in the scapular orientation group with age= 26.45±4.13 years; height= 171.85±7.88 cm; mass= 66.70±10.68 kg; n=21 in the strengthening group with age= 26.43±5.55 years; height= 171.62±5.87 cm; mass= 68.67±10.18 kg). Both groups performed a 30-minute training protocol consisting of three exercises to strengthen the lower trapezius and serratus anterior muscles without overactivating the upper trapezius. Participants in the scapular orientation group were instructed to consciously activate their scapular muscles with electromyographic biofeedback and cues, whereas the strengthening group did not have biofeedback or cues for scapular motion. Corticospinal excitability was assessed using transcranial magnetic stimulation. Scapular kinematics and muscle activation during arm elevation were also measured. After the training, both groups demonstrated a significant increase in motor evoked potentials in lower trapezius (P=0.004) and significant increases in scapular upward rotation (P=0.032), lower trapezius activation (P<0.001), and serratus anterior activation (P<0.001) during arm elevation. Moreover, the scapular orientation group showed higher lower trapezius activation levels during arm elevation following the training, compared with the strengthening group (P=0.028). With or without biofeedback and cues, scapula-focused exercises improved scapular control and increased corticospinal excitability. Adding biofeedback and cues for scapular control during exercise helped facilitate greater lower trapezius activation, and thus, feedback and cues are recommended during scapula-focused training.

American Society of Biomechanics Journal of Biomechanics Award 2021: Exploring the Functional Boundaries and Metabolic Consequences of Triceps Surae Force-Length Relations during Walking

The relationship between individual muscle dynamics and whole-body metabolic cost is not well established. Here we use biofeedback to modulate triceps surae (TS) activity during walking to test the following hypotheses based on basic principles of muscle physiology: (1) increased TS activity would increase metabolic cost via shorter muscle fascicle lengths and thus reduced force capacity and (2) decreased TS activity would decrease metabolic cost via longer muscle fascicle lengths and thus increased force capacity. 23 young adults walked on an instrumented treadmill at 1.25 m/s using electromyographic (EMG) biofeedback to match targets corresponding to ±20 and ±40% TS activity during push-off (late stance). B-mode ultrasound imaged the medial gastrocnemius (MG). Participants increased net metabolic power up to 85% and 21% when targeting increased and decreased TS activity, respectively (p < 0.001). At the instant of peak gastrocnemius force, MG fascicle length was 7% shorter (p < 0.001) and gastrocnemius force was 6% larger (p < 0.001) when targeting + 40% TS activity. Fascicle length was 3% shorter (p = 0.004) and force was 7% lower (p = 0.010) when targeting −40% TS activity; participants were unable to achieve decreased activation targets. MG fascicle length and activity mediated 11.7% (p = 0.036) and 57.2% (p = 0.006) of the changes in net metabolic power, respectively. MG force did not mediate changes in net metabolic power (p = 0.948). These findings suggest that changes in the functional operating length of muscle, induced here by volitional changes in TS activity, mediated changes in the metabolic cost of walking, relatively independently of force. Thus, shifts to shorter fascicle lengths (e.g., aging) may mediate activity-induced increases in metabolic cost.

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.

Enhancing Functional Ability in Chronic Nonspecific Lower Back Pain: The Impact of EMG-Guided Trunk Stabilization Exercises.

Nonspecific lower back pain (NSLBP) is described as pain that is not caused by an identifiable, well-known disease, such as infection, tumor, osteoporosis, fracture, structural deformity, inflammatory condition, radicular syndrome, or cauda equina syndrome. The aim of this study was to determine the effect of EMG-guided trunk stabilization exercises on functional disability associated with LBP. A single-blinded pre- and post-test experimental comparative design was used for this study. Fifty individuals with chronic NSLBP were screened for inclusion criteria. Of these, forty were randomly grouped into the EMG group receiving trunk-stability exercises with electromyography biofeedback and non-EMG group receiving trunk-stabilization exercises without EMG biofeedback. Participants performed five trunk-stability exercises 3 days a week for 4 weeks. The intensity of pain, range of motion, functional disability, and balance were measured at baseline and after 4 weeks. Both techniques indicated a significant effect on chronic NSLBP; however, trunk-stability exercises combined with EMG biofeedback produced better results in alleviating the intensity of pain, increasing the range of motion, and improving functional disabilities and static balance. The present study confirms that trunk-stability exercises with EMG biofeedback can be practiced safely, contributes to a greater boost in neuromuscular efficiency in the lumbar flexors and extensors, and is effective in modifying functional disability for patients with NSLBP.

Investigating the Effects of EMGBF Combined with Different Motion Directions on Improving Upper Limb Function, iEMC, and Pain in Patients with Shoulder Dislocation.

The dislocation of the shoulder is a common complication of stroke, which is easy to occur after 3 months of stroke, with an incidence of 70%. There is no single standard for the pathogenesis of the disease, but the atrophy of the associated stability muscle, such as the triangle muscle, the oblique, and the upper muscle of the gonfield, may be the cause of the disease. In order to observe the effects of Electromyographic Biofeedback (EMGBF) combined with different motion directions on upper limb function with shoulder dislocation, a total of 84 patients with shoulder dislocation from May 2020 to February 2022 are selected for the study. The experimental results show that after treatment, upper limb motor function, iEMC, pain score, Barthel index, and quality of life score in the observation group are significantly higher than those in the control group, with statistical significance.