Article

Effect of biofeedback accompanying occupational therapy and functional electrical stimulation in hemiplegic patients.

Department of Rehabilitation Medicine, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil.
International Journal of Rehabilitation Research (Impact Factor: 1.06). 04/2008; 31(1):33-41. DOI: 10.1097/MRR.0b013e3282f4524c
Source: PubMed

ABSTRACT 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.

4 Bookmarks
 · 
521 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This paper reviews the literature relating to the biofeedback used in physical rehabilitation. The biofeedback methods used in rehabilitation are based on biomechanical measurements and measurements of the physiological systems of the body. The physiological systems of the body which can be measured to provide biofeedback are the neuromuscular system, the respiratory system and the cardiovascular system. Neuromuscular biofeedback methods include electromyography (EMG) biofeedback and real-time ultrasound imaging (RTUS) biofeedback. EMG biofeedback is the most widely investigated method of biofeedback and appears to be an effective in the treatment of many musculoskeletal conditions and in post cardiovascular accident (CVA) rehabilitation. RTUS biofeedback has been demonstrated effective in the treatment of low back pain (LBP) and pelvic floor muscle dysfunction. Cardiovascular biofeedback methods have been shown to be effective in the treatment of a number of health conditions such as hypertension, heart failure, asthma, fibromyalgia and even psychological disorders however a systematic review in this field has yet to be conducted. Similarly, the number of large scale studies examining the use of respiratory biofeedback in rehabilitation is limited. Measurements of movement, postural control and force output can be made using a number of different devices and used to deliver biomechanical biofeedback. Inertial based sensing biofeedback is the most widely researched biomechanical biofeedback method, with a number of studies showing it to be effective in improving measures of balance in a number of populations. Other types of biomechanical biofeedback include force plate systems, electrogoniometry, pressure biofeedback and camera based systems however the evidence for these is limited. Biofeedback is generally delivered using visual displays, acoustic or haptic signals, however more recently virtual reality (VR) or exergaming technology have been used as biofeedback signals. VR and exergaming technology have been primarily investigated in post-CVA rehabilitation, however, more recent work has shown this type of biofeedback to be effective in improving exercise technique in musculoskeletal populations. While a number of studies in this area have been conducted, further large scale studies and reviews investigating different biofeedback applications in different clinical populations are required.
    Journal of NeuroEngineering and Rehabilitation 06/2013; 10(1):60. · 2.57 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The subjects of this study were 30 hemiplegia patients whose disease duration was over 6 months, and they were divided at random into a control group (n=15) receiving traditional rehabilitation therapy and an experimental group (n=15) receiving both traditional rehabilitation therapy and training using IT based EMG biofeedback. The program was applied for a total of 4 weeks. In order to examine the subjects' functional recovery, we measured their upper limb function using FMA and MFT, and activities of daily living using FIM before and after the training. Comparison between experimental groups in the study of upper extremity function improved after training in all tests was higher compared to the control group significantly (p
    The Journal of the Korea institute of electronic communication sciences. 01/2014; 9(1).
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Few studies have addressed the rehabilitation of hand function in persons with severe impairment following stroke, and few therapeutic options are available for treatment. We investigated whether an intervention of robot-assisted movement and muscle vibration could reduce impairment and enable hand-opening to a greater extent when combined with torque biofeedback or electromyographic (EMG) biofeedback. Forty-three participants with severe hand impairment due to chronic stroke (≥1 year poststroke) were randomized to 1 of 2 treatment groups receiving assisted movement and muscle vibration combined with either torque or EMG biofeedback. Each participant received 30 sessions (30 minutes duration per session) directed at the impaired hand over 10 to 12 weeks. Outcomes were assessed using the Upper Extremity Fugl-Meyer Assessment (UE-FMA), Stroke Impact Scale, and Box-and-Block Test scores. Twenty-eight of 43 participants had no baseline finger extension; the remainder had an average of 23 ± 26 mm extension in the most active finger. Assisted movement and muscle vibration were associated with a significant increase in all outcome measures across both treatment groups, and for the UE-FMA and Stroke Impact Scale within treatment groups, with no significant difference between groups. Based on the Box-and-Block Test scores, the assisted movement and muscle vibration intervention did not restore functional hand-opening to participants with baseline UE-FMA scores less than 17/66, regardless of the form of biofeedback. Assisted movement and muscle vibration, combined with either EMG or torque biofeedback, appears to reduce upper limb impairment, improve volitional activation of the hand muscles, and restore a modicum of hand function in some persons with severe hand impairment due to chronic stroke.Video Abstract available (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A64) for more insights from the authors.
    Journal of neurologic physical therapy: JNPT 12/2013; 37(4):194-203. · 1.65 Impact Factor