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Evidence summaries

Electromyographic Biofeedback for the Recovery of Motor Function after Stroke

Electromyographic biofeedback is probably not superior over standard physiotherapy for the recovery of motor function after stroke. Level of evidence: "C"

A Cochrane review [Abstract] 1 included 13 studies with a total of 269 subjects. All trials compared electromyographic biofeedback (EMG-BFB) plus standard physiotherapy to standard physiotherapy either alone or with sham EMG-BFB. Only one study used a motor strength assessment scale for evaluation of patients, which indicated benefit from EMG-BFB (WMD 1.09, 95% CI 0.48 to 1.70). EMG-BFB did not have a significant benefit in improving range of motion (ROM) through the ankle (SMD 0.05, 95% CI -0.36 to 0.46), knee or wrist joints. However, one trial suggested a benefit in ROM at the shoulder (SMD 0.88, 95% CI 0.07 to 1.70). Change in stride length or gait speed was not improved by EMG-BFB. Two studies used different assessment scores to quantify gait quality. One of these suggested a beneficial effect of EMG-BFB (SMD 0.90, 95% CI 0.01 to 1.78). Most of the studies examining functional outcomes used different assessment scales, which made meta-analysis impossible. Two studies that used the same scale did show a beneficial effect (SMD 0.69, 95% CI 0.15 to 1.23).

Comment: The quality of evidence is downgraded by imprecise results (few patients and wide confidence intervals) and by study quality (inadequate allocation concealment).

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Primary/Secondary Keywords