https://www.fysiosupplies.nl/media/PDF/Comparing_biofeedback_with_active_and_passive_treatment_for_the_management_of_work-related_neck_and_shoulder_pain.pdf

Comparing Biofeedback With Active Exercise and Passive Treatment for the Management of Work-Related Neck and Shoulder Pain: A Randomized Controlled Trial

A test of two training interventions to prevent work-related musculoskeletal disorders of the upper extremity.

Objectives Lumbar flexion-relaxation is a well-known phenomenon that can reliably be seen in normal participants, but not in most chronic low back pain (CLBP) participants. No earlier studies have investigated any specific clinical intervention designed to correct abnormal flexion-relaxation. The objective of this study was to evaluate the contribution of a surface EMG-assisted stretching (SEMGAS) biofeedback training protocol, within a functional restoration treatment program, on flexion range of motion (ROM) and erector spinae surface EMG (SEMG) during maximum voluntary flexion (MVF). Methods Lumbar flexion ROM and MVF SEMG were assessed in 2 groups of CLBP patients at the beginning and end of rehabilitation. One group participated in functional restoration only, whereas the other group participated in functional restoration plus SEMGAS biofeedback training. Both treatment groups were compared with a separate control group of normal, pain-free participants. Results Pretreatment ROM and MVF SEMG measures were similar in both treatment groups, but were very different than the control group. At posttreatment, the functional restoration only group remained statistically different than the control group on MVF SEMG and some ROM measures, but the SEMGAS group was statistically equivalent to the control participants on all posttreatment measures, including the ability to show flexion-relaxation. Discussion Interdisciplinary functional restoration rehabilitation of CLBP participants is effective for increasing ROM and other functional measures, but the addition of a SEMGAS biofeedback training protocol can result in normalization of the flexion-relaxation phenomenon, so that these participants are comparable with a pain-free control group.

/pdf/correcting-abnormal-flexion-relaxation-in-chronic-lumbar-4u46zz5nhd.pdf

Correcting Abnormal Flexion-Relaxation in Chronic Lumbar Pain: Responsiveness to a New Biofeedback Training Protocol

Objective: To evaluate the effectiveness of surface electromyographic (EMG) biofeedback training as a supplement to an interdisciplinary rehabilitation programme regarding consequences for activities of daily living and pain.Design: A randomized controlled unblinded trial.Settings: The study was carried out in a pain unit at a rehabilitation centre.Subjects: Sixty-five people with chronic whiplash-associated disorders consecutively referred to the pain unit agreed to participate in the study. Participants were randomly assigned to either the treatment or control group.Intervention: All participants received interdisciplinary rehabilitation and the treatment group also had four weeks of surface EMG biofeedback training.Main measures: The Canadian Occupational Performance Measure was used at admission discharge and at six-month follow-up to register changes in activities of daily living. The Multidimensional Pain Inventory, Swedish version, was used at admission and at six-month follow-up to capture the mul...

Is surface EMG biofeedback an effective training method for persons with neck and shoulder complaints after whiplash-associated disorders concerning activities of daily living and pain - a randomized controlled trial

The aim of this study was to investigate the influence of different intermittent myofeedback training schedules, as provided by a Cinderella-based myofeedback system, on learning relaxation and resistance to extinction of the trapezius muscle, in subjects performing a unilateral gross-motor task. Eighteen healthy subjects performed the task without and with feedback to study baseline and learning relaxation. Subsequently, resistance to extinction was investigated by performing the task without feedback. The gross-motor task consisted of continuously moving the dominant arm between three target areas at a constant pace. Subjects were randomly assigned into three groups, characterized by the sequence of feedback schedules with which the task was performed on 3 consecutive days. Auditory feedback was provided after a 5-, 10-, or 20-s interval when a pre-set level of 80% rest was not reached. Bipolar surface electromyography recordings performed at the dominant upper trapezius muscle were quantified using relative rest time (RRT) and root mean square (RMS) parameters. Learning relaxation was defined as an increase in RRT and a decrease in RMS values. Results showed the highest RRT levels as well as a decrease in RMS for the 10-s schedule. Additionally, the 10-s schedule was unique in its ability to elevate muscular rest above the 20% level, which may be considered relevant in preventing myalgia. None of the three schedules showed resistance to extinction. It was concluded that the 10-s interval was preferred over the 5- and 20-s schedules in learning trapezius relaxation in subjects performing a unilateral gross-motor task.

The influence of different intermittent myofeedback training schedules on learning relaxation of the trapezius muscle while performing a gross-motor task.

Work-related upper extremity disorders (WRUEDs) continue to present significant treatment and financial challenges to providers, employers, and insurers. This retrospective study reviews outcomes for 309 subjects who, between 1995 and 1999, were referred through the workers' compensation system for treatment of computer keyboard- and mouse-related WRUED injuries. The mean length of time from the recorded date of injury to the date of intake was 12.9 months. Subjects were offered a 12-visit course in muscle learning therapy (MLT). MLT is an operant conditioning program which uses surface electromyography (sEMG) to train injured workers to control their muscles during work activities. Patient response to therapy was obtained by a therapist-administered questionnaire during Visit 8 of 12. A group of 309 subjects, who had failed to respond to a previous course of therapy (typically physical therapy), reported significant improvements of pain in the neck, thorax, and upper extremities. Ninety six percent reported that they felt “more in control,” 86% reported feeling “better overall,” and 81% reported either “working the same and feeling better” or “working and accomplishing more.” This study provides preliminary support for this approach and provides justification for controlled clinical trials in the future.

Muscle learning therapy--efficacy of a biofeedback based protocol in treating work-related upper extremity disorders.

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Muscle learning therapy--efficacy of a biofeedback based protocol in treating work-related upper extremity disorders.