Efficacy of electromyographic biofeedback compared with conventional physical therapy for upper-extremity function in patients following stroke: a research overview and meta-analysis.

BACKGROUND AND PURPOSE The purpose of this study was to examine the efficacy of electromyographic biofeedback compared with conventional physical therapy for improving upper-extremity function in patients following a stroke. SUBJECTS AND METHODS A literature search was done for the years 1976 to 1992. The selection criteria included single-blinded randomized control trials. Study quality was assessed for nine criteria. For functional (disability index or stage of recovery) and impairment outcomes, meta-analyses were performed on odds ratios for improvement versus no improvement. Mann-Whitney U-Test probability values were combined across studies. RESULTS Six studies were selected, and outcome data were obtained for five studies. The common odds ratio was 2.2 for function and 1.1 for impairments in favor of biofeedback. The estimate of the number needed to treat to prevent a nonresponder was 11 for function and 22 for impairments. None of the meta-analyses were statistically significant. CONCLUSIONS AND DISCUSSION The results do not conclusively indicate superiority of either form of therapy. Although there is a chance of Type II error, the estimated size of the effect is small. Given this estimate of little or no difference, therapists need to consider cost, ease of application, and patient preference when selecting these therapies.

[1]  R. Lyle.  A performance test for assessment of upper limb function in physical rehabilitation treatment and research , 1981, International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation.

[2]  G. Müller,et al.  [Movement therapy in hemiplegia]. , 1977, Beitrage zur Orthopadie und Traumatologie.

[3]  D. Marcer.  BIOFEEDBACK AND RELATED THERAPIES IN CLINICAL PRACTICE , 1987, Clinical psychology forum.

[4]  R. Wagenaar,et al.  The functional recovery of stroke: a comparison between neuro-developmental treatment and the Brunnstrom method. , 2020, Scandinavian journal of rehabilitation medicine.

[5]  E. Ernst,et al.  A review of stroke rehabilitation and physiotherapy. , 1990, Stroke.

[6]  K A L'Abbé,et al.  Meta-analysis in clinical research. , 1987, Annals of internal medicine.

[7]  S L Wolf,et al.  Electromyographic biofeedback applications to stroke patients. A critical review. , 1983, Physical therapy.

[8]  D. Carroll,et al.  A QUANTITATIVE TEST OF UPPER EXTREMITY FUNCTION. , 1965, Journal of chronic diseases.

[9]  N. Mroczek,et al.  Electromyographic feedback and physical therapy for neuromuscular retraining in hemiplegia. , 1978, Archives of physical medicine and rehabilitation.

[10]  J. John.  Failure of electrical myofeedback to augment the effects of physiotherapy in stroke , 1986, International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation.

[11]  C. Winstein.  Knowledge of results and motor learning--implications for physical therapy. , 1991, Physical therapy.

[12]  K. Lee,et al.  Myofeedback for muscle retraining in hemiplegic patients. , 1976, Archives of physical medicine and rehabilitation.

[13]  Laurence P. Ince,et al.  EMG biofeedback with the upper extremity: A critical review of experimental foundations of clinical treatment with the disabled. , 1987 .

[14]  K. N. Smith.  Biofeedback in strokes. , 1979, The Australian journal of physiotherapy.

[15]  F. Nouri,et al.  The effectiveness of EMG biofeedback in the treatment of arm function after stroke. , 1989, International disability studies.

[16]  M. Baker,et al.  EMG biofeedback in stroke: effect of patient characteristics. , 1979, Archives of physical medicine and rehabilitation.

[17]  J V Basmajian,et al.  EMG feedback treatment of upper limb in hemiplegic stroke patients: a pilot study. , 1982, Archives of physical medicine and rehabilitation.

[18]  Effect of EMG feedback on paretic muscles and abnormal co-contraction in the hemiplegic arm, compared with conventional physical therapy. , 1982, Scandinavian journal of rehabilitation medicine.

[19]  A. Fugl-Meyer,et al.  The post-stroke hemiplegic patient. 1. a method for evaluation of physical performance. , 1975, Scandinavian journal of rehabilitation medicine.