Biofeedback- upper extremity
Introduction
Biofeedback (BFB) is commonly used as a treatment intervention for stroke rehabilitation. Following a stroke, the main central motor pathways that regulate normal muscle tone and functioning can be disrupted or even damaged. However, some motor pathways that are often unused remain relatively unaffected by the stroke. Individuals may learn how to activate these unused pathways with the help of electromyographic biofeedback (EMG-BFB) and this may lead to improvements in their muscle tone and functioning. Given that hemiparesis of the upper extremity can result in functional disability following stroke and can affect important aspects of daily living (i.e. feeding and dressing), the use of EMG-BFB as an effective means of treatment for upper extremity hemiparesis has been carefully studied. Specifically, studies have examined the use of biofeedback to improve hand function as well as upper extremity range of motion and function.
Authors*: Robert Teasell, MD; Norine Foley, BASc; Sanjit Bhogal, MSc; Jamie Bitensky, MSc OT; Mark Speechley, MD; Nicol Korner-Bitensky, PhD OT
*high quality = PEDro score 6-10
*fair quality = PEDro score 4-5
*poor quality = PEDro score ≤ 3
The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/
*high quality = PEDro score 6-10
*fair quality = PEDro score 4-5
*poor quality = PEDro score ≤ 3
The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/
A randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness.
| 1a (Strong) | Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings |
| 1b(Moderate) | 1 RCT of high quality (PEDro ≥ 6) |
| 2a (Limited) | At least 1 fair quality RCT (PEDro = 4-5) |
| 2b (Limited) | At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.) |
| 3(Consensus) | Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results |
| 4 (Conflicting) | Conflicting evidence of 2 or more equally well-designed studies |
| 5 (No evidence) | No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines) |
A randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness.
*high quality = PEDro score 6-10
*fair quality = PEDro score 4-5
*poor quality = PEDro score ≤ 3
The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/
*high quality = PEDro score 6-10
*fair quality = PEDro score 4-5
*poor quality = PEDro score ≤ 3
The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/
| 1a (Strong) | Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings |
| 1b(Moderate) | 1 RCT of high quality (PEDro ≥ 6) |
| 2a (Limited) | At least 1 fair quality RCT (PEDro = 4-5) |
| 2b (Limited) | At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.) |
| 3(Consensus) | Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results |
| 4 (Conflicting) | Conflicting evidence of 2 or more equally well-designed studies |
| 5 (No evidence) | No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines) |
*high quality = PEDro score 6-10
*fair quality = PEDro score 4-5
*poor quality = PEDro score ≤ 3
The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/
A randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness.
| 1a (Strong) | Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings |
| 1b(Moderate) | 1 RCT of high quality (PEDro ≥ 6) |
| 2a (Limited) | At least 1 fair quality RCT (PEDro = 4-5) |
| 2b (Limited) | At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.) |
| 3(Consensus) | Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results |
| 4 (Conflicting) | Conflicting evidence of 2 or more equally well-designed studies |
| 5 (No evidence) | No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines) |