Effect of EMG Biofeedback to Improve Hand Function in
Children with Cerebral Palsy: A Randomized Controlled Trial
1 Physical Medicine and Rehabilitation Department, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Affiliation :
Rattana Rattanatharn MD1
Background : Cerebral palsy has pathology in immature brain problem; ischemic brain, hypoxic brain. The cause of pathology can
be prenatal, perinatal and postnatal. Electromyographic (EMG) biofeedback is muscles training by using electrical stimulation
modality to train speci(cid:976)ic weakness muscles or pathologic side. Feedback response to the patients by visual or evidence supporting
sound can make the patients to train themselves speci(cid:976)ically. However, there is only few evidences supporting ef(cid:976)icacy of EMG
biofeedback to train muscles in cerebral palsy.
Objective : To study the effect of EMG biofeedback on upper extremity to improve hand function in children with cerebral palsy.
Materials and Methods : Forty children with cerebral palsy who had impairment of upper extremity and hand function. They were
randomly assigned into two groups. The biofeedback group consisted of 20 patients, each received EMG biofeedback training of
3 muscles for 30 minutes plus three-task training for 30 minutes. The conventional group consisted of 20 patients, each received
three-task training for 60 minutes. Upper extremity and hand function were evaluated before starting training, at 4 weeks and 8 weeks.
Results : The biofeedback group displayed statistically signi(cid:976)icant improvement regarding 3 subtest of Jebsen hand function test
(JHFT) (p=0.004, 0.017, 0.004), respectively. Comparing with before starting training, mean decreasing of time spending at 4th
week were 15.03±4.01, 232.42±74.52 and 14.24±3.80, and at 8th week were 13.32±2.70, 251.85±80.25 and 10.34±3.28. There were
signi(cid:976)icant improvement in almost all aspect of range of motion (ROM) of elbow and wrist joints (p<0.05) and modi(cid:976)ied tardieu
scale (MTS) of elbow (cid:976)lexors and wrist (cid:976)lexors (p<0.005). Conventional group displayed statistically signi(cid:976)icant improvement
regarding 1 subtest of JHFT (p=0.006). Comparing with before starting training, mean decreasing of time spending at 4th week were
174.90±49.20. Biofeedback group showed statistically signi(cid:976)icant progress over conventional group in 1 subtest of JHFT (p=0.002,
0.005), MTS of elbow (cid:976)lexors (p<0.001, 0.007) and ROM of elbow extension (p=0.018).
Conclusion : The effect of EMG biofeedback on upper extremity and hand function in children with cerebral palsy especially in large
muscle trained by EMG biofeedback is superior to conventional therapy.
Keywords : EMG biofeedback, Electromyographic biofeedback, Upper extremity and hand function, Cerebral palsy
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