Date Presented 04/03/2025
The literature to support electromyographic biofeedback (EMG BF) interventions in upper extremity neurorehabilitation is mixed. This review categorizes EMG BF using motor learning principles to help guide professional reasoning.
Primary Author and Speaker: Marissa R. Mirecki
Contributing Authors: Edelle C. Field-Fote
PURPOSE: Occupational therapy practitioners (OTPs) play a key role in upper extremity rehabilitation following a stroke or spinal cord injury (SCI) by promoting motor recovery and compensatory strategy training. Electromyography biofeedback (EMG BF) interventions have been used to address these goals, however, the evidence to support their efficacy is mixed (Balbinot et al., 2022). This review categorizes the EMG BF literature according to the motor learning principles underlying each intervention approach.
METHOD: Articles that described EMG BF interventions to address UE deficits in individuals with stroke and SCI were included in the review. Articles were assessed based on experimental design, type of intervention provided, and results obtained.
RESULTS: Of the 12 EMG BF studies identified, seven protocols provided knowledge of results (KR) feedback and five protocols provided knowledge of performance (KP) feedback. Of the protocols that provided KR feedback, two used an experimental design and demonstrated that EMG BF was more effective than usual care. Five of the KR feedback protocols used a quasi-experimental pre-post design and studied high-tech interventions such as video games and exoskeletons. All showed significant improvement from pre-test to post-test. All protocols that provided KP feedback used an experimental design and concluded the EMG BF was not more effective than usual care.
CONCLUSIONS: Interventions that provide KR feedback are more efficacious compared to usual care than those that provide KP. This method of categorizing interventions is not commonly used in the literature and is recommended for OTPs when engaging in professional reasoning.
IMPACT STATEMENT: This study describes a criterion OTPs can use to aid in clinical decision-making for UE neurorehabilitation.
References
Winstein, C., Lewthwaite, R., Blanton, S. R., Wolf, L. B., & Wishart, L. (2014). Infusing motor learning research into neurorehabilitation practice: A historical perspective with case exemplar from the accelerated skill acquisition program. Journal of Neurologic Physical Therapy, 38(3), 190–200. https://doi.org/10.1097/NPT.0000000000000046
Balbinot, G., Wiest, M. J., Li, G., Pakosh, M., Furlan, J. C., Kalsi-Ryan, S., & Zariffa, J. (2022). The use of surface EMG in neurorehabilitation following traumatic spinal cord injury: A scoping review. Clinical Neurophysiology, 138, 61–73. https://doi.org/10.1016/j.clinph.2022.02.028
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