EMG feedback treatment of upper limb in hemiplegic stroke patients: a pilot study. Rehabilitation of Walking With Electromyographic Biofeedback in Foot‐Drop After Stroke Electromyographic biofeedback for gait training after stroke Electromyographic versus rhythmic positional biofeedback in computerized gait retraining with stroke patients. Electromyographic feedback in the remobilization of stroke patients: a controlled trial. Electromyographic biofeedback and physical therapy of the hemiplegic upper limb. Overcoming limitations in elbow movement in the presence of antagonist hyperactivity. EMG feedback and the restoration of motor control. A controlled group study of 12 hemiparetic patients. The effectiveness of EMG biofeedback in the treatment of arm function after stroke. Stroke treatment: comparison of integrated behavioral-physical therapy vs traditional physical therapy programs. Electromyographic Biofeedback in the Treatment of the Hemiplegic Hand: A Placebo-Controlled Study Biofeedback in strokes.
Poor prognosis for upper limb recovery of stroke survivors has not changed in at least 28 years ; only 4 % to 5 % of patients regain arm function during or after the active rehabilitation phase . This pilot study included 37 patients r and omly assigned to either an integrated behavioral-physical therapy treatment program including electromyographic feedback ( experimental group ) or a st and ard exercise physical therapy program of like duration and intensity ( control group ) . Both groups showed clinical ly significant improvements that exceeded previously reported experience . The experimental technique appears to be more effective when upper limb involvement is not severe in a late case , or when treatment is started early ( within 3 months poststroke ) in a severe case . The rehabilitation community should quickly investigate the improved prospect s of restoring a greater number of useful upper limbs in this often neglected group of hemiplegic patients Background and Purpose 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 . Methods 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 . Results 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 . Conclusions 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 Objective : To examine the effects of electromyographic ( EMG ) biofeedback training on the recovery of gait in the acute phase post stroke . Design : Patients were r and omly assigned to EMG biofeedback or control groups . They received treatment three times a week for six weeks . All patients were assessed prior to treatment , after 18 treatment sessions , and at three months follow-up . Setting : The study was carried out at Scunthorpe General Hospital in North Lincolnshire . The subjects were acute stroke patients who had been admitted on to the medical and elderly wards . Interventions : The EMG biofeedback group were treated using EMG as an adjunct to physiotherapy . The patients were encouraged to facilitate or inhibit abnormal muscle tone via auditory or visual signals transmitted from electrodes placed over the appropriate muscles . The control group were treated using the same techniques , electrodes were used with this group of patients , but the EMG machine was turned off and faced away from the patient and the therapist to control the placebo effect . Outcome measures : A large battery of outcome measures was used for physical and psychological assessment . The physical measures consisted of active movement , muscle tone , sensation , proprioception , mobility and activities of daily living ( ADL ) . The psychological measures included orientation , memory , spatial performance , language and IQ . Results : Twenty-one patients were included in the study . Scores were combined into four groups : mild EMG , severe EMG , mild control and severe control . Results showed that there was an improvement in physical scores for active movement , mobility and ADL over time , but there was no significant difference between the EMG and control groups . Scores on the psychological tests were within normal limits , and there was no difference in performance between the EMG and control groups . Conclusions : This study showed no significant differences in the rate of improvement after stroke between the two groups . Although EMG biofeed-back was used as an adjunct to physiotherapy and represented clinical practice , the results provide little evidence to support the clinical significance of using EMG biofeedback to improve gait in the acute phase after stroke This research provides a preliminary investigation of the relative efficacy of electromyographic ( EMG ) versus a novel biofeedback ( BFB ) approach to improve ankle control and functional gait in stroke patients . A computerized system was design ed to provide audiovisual feedback of either muscle activity or ankle position during dorsiflexion and plantar flexion . The novel approach also included rhythmic pacing to emphasize the rapid timing of ankle motion necessary to switch from stance to swing during walking . Thirty-seven subjects were r and omly assigned to one of the following groups : ( 1 ) no-treatment control , ( 2 ) EMG BFB , and ( 3 ) rhythmic positional BFB . Blind evaluations of ankle performance , gait , and perceived exertion were performed at regular intervals . Analyses of covariance revealed that subjects receiving rhythmic positional BFB significantly increased their walking speeds relative to other groups at posttest ( p = .02 ) and at three-month follow-up ( p = .035 ) , without any increase in subjectively reported energy cost . The ability of positional BFB to emphasize the timing events during walking provided optimistic results for carry-over into gait functioning . The degree of sensorimotor recovery and time since onset of stroke were considered important factors in determining outcomes Electromyographic biofeedback was compared with simple exercise therapy as to its effectiveness in improving  foot-drop in 22 stroke patients . The study was design ed to be a rigorous trial of biofeedback and the patients tested were aged and had stroke of long duration . One group of 11 patients underwent 6 weeks of exercise therapy 2 sessions per week for 15 minutes per session ; the 2nd group of 11 patients underwent similar therapy with EMG feedback . All therapy was conducted by a research assistant who was not a trained therapist . The groups were assessed blind before treatment , after treatment and a 6-week follow-up . The significantly greater improvements in the biofeedback group in terms of muscle strength at the end of treatment were maintained at follow-up . On the range of movement and gait analysis measures , both groups showed some improvement after treatment . However , at follow-up this improvement had relapsed for the exercise group while for the biofeedback group it had been maintained . It is argued that controlled trials are possible in biofeedback and that using patients as their own controls is not justified in view of the present findings and the previously reported literature A long-term , comparison-group outcome trial with a partial crossover design was carried out on the effects of  electromyographic biofeedback ( EMGBF ) plus physiotherapy ( PT ) versus PT alone in the treatment of the hemiplegic upper limb in stroke patients who were at least six months beyond the onset of their disability . Both the experimental and the control groups benefited from their treatment , but EMGBF was shown to have an additional effect , both in the experimental patients , and in the control patients when they switched over to the experimental treatment condition BACKGROUND AND PURPOSE A traditional perspective on rehabilitation of patients with abnormal muscular hyperactivity presumes that relaxation should be facilitated prior to recruitment of antagonists , if effective movement about a joint is to occur . The purpose of the study was to determine the effect of training weak triceps brachii muscles , with hyperactivity present in the opposing biceps brachii muscles , on elbow function in individuals at least 1 year poststroke . SUBJECTS Sixteen patients with chronic stroke were r and omly assigned to receive electromyographic biofeedback to retrain the triceps muscle ( n = 8) or to receive conventional movement training ( n = 8) . METHODS Both groups participated in 5 baseline and 10 training sessions involving tasks requiring elbow extension . Preintervention and postintervention measurements included elbow extension range of motion , triceps and biceps muscle electromyographic activity during performance of elbow extension , resisted elbow extension , and a reaching task . RESULTS Two- sample t-test results of between-group comparisons for each variable were not significant . One- sample t-test results of within-group comparisons showed significant increases in triceps muscle mean electromyographic activity during two of the three tasks for the feedback group , but not for the nonfeedback group . Passive and active range of motion in both groups increased significantly , although biceps muscle co-contraction persisted . CONCLUSION AND DISCUSSION These results suggest that functional improvements at the elbow may have been due to biomechanical ( peripheral ) rather than neuromuscular ( central ) changes about the joint . Furthermore , these preliminary data indicate that patients with stroke may be trained to increase movement without first being trained to specifically inhibit hyperactivity in muscles A controlled group study involving 12 patients was performed with the purpose of comparing the effects of EMG feedback in the (re-)learning of motor control to the effects of a conventional physical therapy procedure ( NDT ) . The therapy was focussed on the improvement of the dorsiflexion function of the foot . Special attention was given to the measurement and evaluation of functional parameters ( range of motion and gait ) . The results indicated no significant differences between the two methods . The implication s of the results for the employment of EMG feedback and other therapeutic procedures in motor rehabilitation are discussed The study was design ed to evaluate the effect of electromyographic ( EMG ) biofeedback on the recovery of arm function after stroke . Patients who had impaired arm function and were between 2 and 8 weeks after stroke were r and omly allocated to receive either treatment incorporating EMG biofeedback or a control treatment in addition to their routine physiotherapy . The two groups of 20 patients were compared before and after 6 weeks of treatment and at follow-up 6 weeks later . There were no significant differences between the groups before treatment or at follow-up , but at the end of treatment those who received EMG biofeedback scored significantly higher on tests of arm function .  Patients with severe impairment were shown to benefit most from EMG biofeedback but there was no difference in response to treatment according to patient 's age or side of stroke . Men had higher arm function scores than women before and at the end of treatment , but not at follow-up This was a controlled study of the efficacy of two forms of therapy on upper limb functions of hemiparetic patients --one  heavily behavioral and the other based on Bobath therapeutic exercises . It arose from an earlier pilot study comparing EMG biofeedback with physical therapy from which it was concluded that both the elapsed time since the acute stroke and the severity of residual disability were particularly important factors . Of 29 patients included and r and omly assigned to one or the other heavily systematized therapies  , 18 were classified as having early-severe and 11 as late-mild conditions . Multiple function tests by a " blinded " special technician in another location revealed that overall both forms of therapy obtained worthwhile clinical and statistical improvement , which was maintained at nine-month recheck testing ; but there was no statistically significant superiority of one therapy over the other under the very specific circumstances of the research design . Ease of delivering care and other socioeconomic considerations become important factors in choosing either or both of these methods Armagan O , Tascioglu F , Oner C : Electromyographic biofeedback in the treatment of the hemiplegic h and : A placebo-controlled study . Am J Phys Med Rehabil 2003;82:856–861 . Objective To evaluate the efficacy of electromyographic ( EMG ) biofeedback treatment in the functional recovery of the hemiplegic h and . Design A total of 27 patients were r and omly assigned to EMG biofeedback or placebo EMG biofeedback groups . Both treatments were applied five times a week for a period of 20 days . In addition , the patients in both groups received an exercise program according to the Brunnstrom ’s neurophysiologic approach . Goniometric measurements for wrist extension , scale for judging the performance of drinking from a glass , Brunnstrom ’s stages of recovery for h and , and surface EMG potentials were used for the clinical assessment s. All patients were assessed before treatment and after 20 treatment sessions . Results The results showed that there were statistically significant improvements in all variables in both groups , but the improvements in active range of motion and surface EMG potentials were significantly greater in the EMG biofeedback group at the end of the treatment . Conclusion Our study demonstrates the potential benefits of EMG biofeedback in conjunction with neurophysiologic rehabilitation technique to maximize the h and function in hemiplegic patients The effectiveness of  biofeedback therapy , using the electromyograph , was compared with conventional physiotherapy treatments in eleven hemiparetic patients with severe disability of the upper limb . These were divided r and omly into two groups , a group of six patients receiving biofeedback treatments and five receiving physiotherapy treatments with conventional techniques . The results showed greater improvements in the biofeedback group in most fields of testing , and the patients in this group had a greater degree of control over the patterns of movement in the upper limb and the relaxation of spastic muscle groups . It was concluded that a wide range of hemiparetic patients should benefit in some degree by treatment of this form
BACKGROUND Electromyographic biofeedback ( EMG-BFB ) is a technique that is believed to have additional benefit when used with st and ard physiotherapy for the recovery of motor function in stroke patients .
However , evidence from individual trials and previous systematic review s has been inconclusive .
OBJECTIVES To assess the effects of EMG-BFB for motor function recovery following stroke .