Effect of surface electromyographic biofeedback on post-stroke dysphagia: a meta-analysis.

Background: Upper limb motor impairments in children with cerebral palsy (CP), particularly hemiplegic types, limit functional independence and reduce quality of life. Constraint-Induced Movement Therapy (CIMT) and Electromyographic (EMG) Biofeedback are two evidence-based rehabilitative approaches that aim to improve motor outcomes. CIMT facilitates cortical reorganization through intensive, task-specific training of the affected limb, while EMG Biofeedback supports motor learning via real-time visual or auditory feedback on muscle activation. Comparative evidence regarding their effectiveness in pediatric CP remains sparse. Objective: To compare the effects of CIMT and EMG Biofeedback on upper limb motor function, spasticity, and functional hand use in children with spastic hemiplegic CP. Methods: A randomized controlled trial was conducted at a tertiary pediatric rehabilitation center involving 60 children aged 6–12 years with spastic hemiplegic CP (GMFCS Levels I–III). Participants were randomized into two groups: CIMT (n = 30) and EMG Biofeedback (n = 30). Both groups received 2-hour sessions, 5 days a week for 4 weeks. The CIMT protocol included mitt restraint and task-specific training, while the EMG group received guided selective muscle activation training using surface electrodes. Primary outcomes were the Melbourne Assessment of Unilateral Upper Limb Function (MA2), Modified Ashworth Scale (MAS), and Assisting Hand Assessment (AHA). Evaluations were conducted at baseline and after 4 weeks. Results: At baseline, no significant differences were observed between groups (p > 0.05). Post-intervention, the CIMT group demonstrated greater improvements in MA2 scores (52.3 ± 6.8 to 71.2 ± 7.4) compared to EMG Biofeedback (51.9 ± 7.2 to 61.8 ± 8.1; p < 0.001). Spasticity reduced more in CIMT (MAS mean change: −1.5 ± 0.6) than EMG (−0.8 ± 0.5; p < 0.001). AHA scores improved significantly in the CIMT group (45.6 ± 5.5 to 62.3 ± 6.1) versus the EMG group (45.2 ± 5.9 to 54.8 ± 6.7; p < 0.001). Conclusion: CIMT resulted in significantly greater improvements in upper limb function, spasticity reduction, and hand use than EMG Biofeedback. These findings support prioritizing CIMT as a primary rehabilitation strategy in children with hemiplegic CP, with EMG Biofeedback as a supplementary option when CIMT is not feasible.

EMG biofeedback training in adult attention-deficit/hyperactivity disorder: An active (control) training?

Objective To explore the effects of electromyographic biofeedback (EMG-BFB) on the wrist dorsiflexion recovery in children with obstetrical brachial plexus palsy (OBPP) who have undergone neurotization procedures.Methods According to the inclusive criteria of the study 30 children with OBPP were involved.After the nerve transfer surgeries all the patients received routine neurotrophic medication and rehabilitation interventions.In addition,all the children were given EMG-BFB on the affected extensor carpi radialis longus (ECRL).Active wrist extension and average EMG signal of the ECRL were recorded 4 weeks after the treatment and compared with the pre-treatment values.Results All 30 patients were follow-up for evaluation.The posttreatment wrist extension active movement range was (24.57 ± 13.79)°,a significant improvement from the (0.00 ± 14.20)° pre-treatment value (P ＜ 0.01).The average EMG of the ECRL increased from (69.57 ± 39.57) μV to (529.30 ± 293.17) μV (P ＜ 0.01).Conclusion Electromyographic biofeedback could improve wrist dorsiflexion function in children with OBPP. Key words: Brachial plexus; Rehabilitation; Electromyographic biofeedback; Wrist dorsiflexion

Objective To investigate the therapeutic effects of electromyography biofeedback (EMGBF) on motor and psychological function in patients with spinal cord injury (SCI).Methods Seventy SCI patients were randomly divided into research and control groups with 35 patients in each.In addition to conventional rehabilitation,the patients in the research group received EMGBF training while those in the control group were treated with medium frequency electrotherapy.To evaluate the patients' self confidence and motor function of their paralyzed limbs,Rosenberg's self-esteem scale (RSES) and American Spinal Injury Association (ASIA) locomotor function scoring were performed before and six weeks after the interventions in both groups of patients.The changes of EMG of the quadriceps,hamstring and anterior tibial muscles of both groups in maximum contraction were also observed before and six weeks after the interventions.Results There were no significant differences in the RSES scores or ASIA locomotor function results between the groups before the interventions.ASIA locomotor function evaluation scores increased significantly in both groups after the interventions,with significantly better results in the research group.The RSES scores in the research group also improved significantly after the interventions,and RSES scoring and ASIA scoring were positively correlated in those patients.But no significant improvement in average RSES scores was found in the control group.The muscle contraction EMG amplitudes also increased significantly in patients of the research group after the interventions.Conclusions EMGBF training can enhance patients' self-confidence,which helps patients with SCI improve their motor functions. Key words: Spinal cord injury; Electromyographic biofeedback training; Rosenberg self-esteem scale; Medium frequency electrotherapy

The prevalence of chronic low back pain (CLBP) among the Pakistani population is reported to be as high as 78%, leading towards different physiological and psychosocial alterations, with the worst...

Dyssynergic defecation is a usual cause of chronic constipation in elderly women, with a negative impact on health-related quality of life. The present randomized controlled trial aims to evaluate the effects of behavioral treatment through electromyographic biofeedback (EMG-BF) on quality of life and bowel symptoms in elderly women with dyssynergic defecation. Twenty chronically constipated elderly women, due to dyssynergic defecation, were enrolled in the study. Outcome measures included weekly stool frequency, anismus index, severity of patient-reported chronic constipation symptoms (abdominal, rectal, and stool symptoms), and overall measure of quality of life. After 1 month of baseline, participants were randomly assigned to either EMG-BF group (n = 10) or control group (n = 10). Three months after treatment, female patients were once again assessed following the same procedure in baseline. One-way multivariate analysis of variance MANOVA revealed no significant differences between the groups before treatment in any of the measured dependent variables (Wilks’s λ = 0.74; F6,13 = 0.77; p = 0.61). Likewise, univariate analysis showed no differences between the groups, either in terms of age (F1,18 = 0.96; p = 0.34) or mean disease duration (F1,18 = 2.99; p = 0.11). Three months after treatment, MANOVA revealed statistically significant differences between the groups (Wilks’s λ = 0.29; F6,13 = 5.19; p < 0.01). These differences were significant in all outcome measures. EMG-BF produces significant improvements in bowel symptoms and health-related quality of life of elderly women with dyssynergic defecation.

In patients with global brachial plexus injury and lack of biological treatment alternatives, bionic reconstruction, including the elective amputation of the functionless hand and its replacement with a prosthesis, has recently been described. Optimal prosthetic function depends on a structured rehabilitation protocol, as residual muscle activity in a patient's arm is later translated into prosthetic function. Surface electromyographic (sEMG) biofeedback has been used during rehabilitation after stroke, but has so far not been used in patients with complex peripheral nerve injuries. Here, we present our rehabilitation protocol implemented in patients with global brachial plexus injuries suitable for bionic reconstruction, starting from identification of sEMG signals to final prosthetic training. This structured rehabilitation program facilitates motor relearning, which may be a cognitively debilitating process after complex nerve root avulsion injuries, aberrant re-innervation and extra-anatomical reconstruction (as is the case with nerve transfer surgery). The rehabilitation protocol using sEMG biofeedback aids in the establishment of new motor patterns as patients are being made aware of the advancing re-innervation process of target muscles. Additionally, faint signals may also be trained and improved using sEMG biofeedback, rendering a clinically "useless"muscle (exhibiting muscle strength M1 on the British Medical Research Council [BMRC] scale) eligible for dexterous prosthetic hand control. Furthermore, functional outcome scores after successful bionic reconstruction are presented in this article.

Myotherapy intervention in facial aesthetics aims to attenuate wrinkles and signs of facial aging. The relationship between accentuated muscle contraction during chewing, swallowing and speaking and the appearance of facial wrinkles has been suggested by speech-language pathology literature. This study aimed to report the effect of electromyographic biofeedback associated with training of chewing, swallowing, and smiling patterns, during speech therapy intervention aimed at reducing the signs of facial wrinkles and furrows, in a 55-year-old woman. The therapy also included isotonic and isometric exercises and clinical procedures to decrease the contraction of facial mimicry muscles, which were not associated with training using electromyographic biofeedback. Signal collection and training were performed using the Biotrainer software on the New Miotool Face by Miotec, over nine weekly sessions. Two assessments were performed (before and after the nine sessions), using the MBGR Protocol (assessment of chewing, swallowing, and smiling) and validated scales described in the literature (assessment of signs of facial aging). In the reported case, the usefulness of electromyographic biofeedback was verified for learning trained orofacial myofunctional patterns, as well as to improve chewing and swallowing functions and decrease signs of facial aging. However, further research is needed to demonstrate the positive effects of electromyographic biofeedback associated with myofunctional therapy aimed at attenuating the signs of facial aging.

To compare the efficacy of pelvic floor muscle exercises (PFME) with and without electromyographic biofeedback (BF) in increasing muscle strength, improving myoelectric activity, and improving pre-contraction and quality of life in postmenopausal women with stress urinary incontinence. Randomized controlled trial of 49 postmenopausal women with stress urinary incontinence. Participants were allocated across three groups: control, PFME alone, and PFME + BF. Forty-five women completed the study (14 control, 15 PFME, 16 PFME + BF; mean age 58.26 years). Outcome assessment was carried out using digital palpation (modified Oxford grading scale), electromyography, and the International Consultation Incontinence Questionnaire-Short Form (ICIQ-SF) quality of life instrument. The treatment protocol consisted of eight twice-weekly, 20-min one-on-one sessions. Controls were assessed only at baseline and after 1 month. The PFME and PFME + BF groups exhibited significant increases in muscle strength (Oxford scale) (P < 0.0001), precontraction while coughing (P < 0.0001), maximum voluntary contraction, duration of endurance contraction, and ICIQ-SF scores (P < 0.0001). PFME + BF was associated with significantly superior improvement of muscle strength, precontraction while coughing, maximum voluntary contraction, and duration of endurance contraction as compared to PFME alone (P < 0.05). This preliminary study suggests that pelvic floor muscle training, with and without biofeedback, is associated with increased muscle strength, myoelectric activity, precontraction of pelvic floor muscles, and improved quality of life in postmenopausal women with stress urinary incontinence.

Digital devices, particularly smartphones and tablets, are used by the vast majority of the global population. This usage often causes the head to tilt forward, placing significant strain on the neck and shoulders. While this posture adversely affects healthy individuals, it is particularly problematic for scoliosis patients, exacerbating spinal deformation. Therefore, this study evaluates the effectiveness of a 30-session surface electromyography (sEMG) biofeedback posture training program for managing spinal curvature progression in adolescents with mild scoliosis. The program is aimed at reducing imbalanced paraspinal muscle activity and controlling curvature progression. Prior to training, a significant muscle activity imbalance was observed. Posttraining, however, muscle activity becomes more balanced, with significant improvements noted in the latissimus dorsi and thoracic erector spinae muscles. It also demonstrates that the training may assist in stabilizing scoliosis progression. These findings suggest that sEMG biofeedback posture training can be an effective intervention for adolescents with mild scoliosis. However, further research is needed to confirm the findings and explore the intervention's long-term effects.

Introduction: stroke rehabilitation mainly emphasize on improving upper limb function especially on wrist and hand. Even mild improvement to wrist and hand function will reflects on patient outcome and reduces disability. Objective of the study is to determine the effect of Emg biofeedback and NMES on improving the strength and function of wrist and hand muscles in Sub acute MCA stroke patients. Methodology: it is a Pre Vs post experimental design. This study was conducted at Outpatient department of Bethany Navajeevan College of physiotherapy, hospitals in and around Trivandrum 30 subjects with poor hand and wrist function and strength after sub acute MCA stroke whose satisfying inclusion criteria were included in the study. Group a included 15 subjects, was treated with EMG biofeedback, NMES (15hz, pulse width 200ms) and conventional exercises, group b included 15 subjects, was treated with conventional exercises for 6 weeks, 5 days per week. Pre and post tests were conducted on ARAT and MMT. Results: based on statistical analysis, the result of the study shows statistically significant difference in pre-test and post-test values in the ARAT and MMT of the experimental group. Conclusion: the study concludes that the Emg biofeedback and NMES shows significant improvement in strength and function of wrist and hand complex in Sub acute MCA stroke patients.

Early postpartum biofeedback assisted pelvic floor muscle training in primiparous women with second degree perineal laceration: Effect on sexual function and lower urinary tract symptoms

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

IntroductionAsymmetry in paraspinal muscle activities is observed in adolescent idiopathic scoliosis and may be of value for predicting curve progression. We have reported the effects of the surface electromyography biofeedback posture training program in improving the symmetry of paraspinal muscle activities and reducing the curve progression of early adolescents with mild scoliosis. This study further explored their subjective experience of the training program on posture correction and health-related quality of life.MethodsUsing purposive sampling, 13 early adolescents aged between 11 and 13 years with mild scoliosis participated in semi-structured in-depth interviews after completing 30 sessions of training. The data were recorded, transcribed, and coded using thematic analysis with NVivo 10. Significant statements and phrases were categorized into themes and subthemes.ResultsAs assessed by X-ray, five early adolescents showed at least a 5° Cobb angle reduction in spinal curvature, while eight showed no significant curve progression (a Cobb angle change under 5°). Several subthemes related to the benefits of the training program on the health-related quality of life were generated, namely (a) posture correction, (b) improvement in body appearance, (c) restoration of muscle relaxation, (d) reduction in bodily pain and fatigue, (e) enhancement of self-confidence/self-image, and (f) improvement in social functioning.ConclusionsGiven its positive effects, the sEMG biofeedback posture training program has the potential to be an alternative early intervention for early adolescents with mild scoliosis. Further empirical studies need to be carried out to substantiate its effectiveness and evaluate the sustainability of its benefits over time.

The objective of this study was to determine the effect that electromyographic biofeedback (EMG-BFB), used in conjunction with occupational therapy (OT) and functional electrical stimulation (FES), has on spasticity, range of motion, and upper extremity function in hemiplegic patients. A total of 59 patients treated at a university-based rehabilitation centre were studied. Of those 59 patients, 31 received twice-weekly sessions of OT+FES, together with weekly sessions of EMG-BFB, and 28 received only the twice-weekly sessions of OT+FES. The patients were evaluated at baseline, at 6 months, and at 12 months, using the hand function test, the Minnesota manual dexterity test, the joint range of motion scale, and the modified Ashworth scale. At 6 months, the patients receiving EMG-BFB presented significantly greater improvement in upper extremity function than those receiving only OT+FES. Incorporating EMG-BFB into the treatment regimen had a positive effect on the range of motion and on the recovery of upper extremity function in hemiplegic patients. Biofeedback training might represent an important therapeutic tool for the rehabilitation of stroke patients.