Recent developments in biofeedback for neuromotor rehabilitation

Useless. We don't need to broaden a framework. We need protocols that deliver recovery on demand. THIS  is why we need survivors in charge, obviously the mentors and senior researchers do not understand THE ONLY GOAL IN STROKE IS 100% RECOVERY.  This does nothing to get us there.

Recent developments in biofeedback for neuromotor rehabilitation

Address:
1
Center for Neural Interface Design in The Biodesign Institute, and Harrington Department of Bioengineering, Arizona State University,  Tempe, Arizona, 85287, USA,
2
Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, Georgia, 30322, USA and
3
Huazhong University of Science and Technology, Wuhan, ChinaEmail: HeHuang-he.huang@asu.edu; StevenLWolf-swolf@emory.edu; JipingHe*-jiping.he@asu.edu* Corresponding author


BioMed

Central
Page 1 of 12
(page number not for citation purposes)
Journal of NeuroEngineering and Rehabilitation
Open Access
Review
Recent developments in biofeedback for neuromotor rehabilitation
HeHuang
1
, StevenLWolf
2
 and JipingHe*
1,3
 Address:
1
Center for Neural Interface Design in The Biodesign Institute, and Harrington Department of Bioengineering, Arizona State University,  Tempe, Arizona, 85287, USA,
2
Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, Georgia, 30322, USA and
3
Huazhong University of Science and Technology, Wuhan, ChinaEmail: HeHuang-he.huang@asu.edu; StevenLWolf-swolf@emory.edu; JipingHe*-jiping.he@asu.edu* Corresponding author

Abstract

The original use of biofeedback to train single muscle activity in static positions or movement unrelated to function did not correlate well to motor function improvements in patients with central nervous system injuries. The concept of task-oriented repetitive training suggests that biofeedback therapy should be delivered during functionally related dynamic movement to optimize motor function improvement. Current, advanced technologies facilitate the design of novel biofeedback systems that possess diverse parameters, advanced cue display, and sophisticated control systems for use in task-oriented biofeedback. In light of these advancements, this article:(1) reviews early biofeedback studies and their conclusions; (2) presents recent developments in biofeedback technologies and their applications to task-oriented biofeedback interventions; and (3)discusses considerations regarding the therapeutic system design and the clinical application of task-oriented biofeedback therapy. This review should provide a framework to further broaden the application of task-oriented biofeedback therapy in neuromotor rehabilitation.
Review of early biofeedback therapy
Biofeedback can be defined as the use of instrumentation to make covert physiological processes more overt; it also includes electronic options for shaping appropriate responses [1-3]. The use of biofeedback provides patients with sensorimotor impairments with opportunities to regain the ability to better assess different physiological responses and possibly to learn self-control of those responses [4]. This approach satisfies the requirement for a therapeutic environment to "heighten sensory cues that inform the actor about the consequences of actions (for- ward modeling) and allows adaptive strategies to besought (inverse modeling)" [5]. The clinical application of biofeedback to improve a patient's motor control begins by re-educating that control by providing visual or audio feedback of electromyogram (EMG), positional or force parameters in real time [6,7]. Studies on EMG bio-feedback indicated that patients who suffer from sensorimotor deficits can volitionally control single muscleactivation and become more cognizant of their own EMGsignal [8,9]. The neurological mechanisms underlying theeffectiveness of biofeedback training are unclear, how-ever. Basmajian [10] has suggested two possibilities:either new pathways are developed, or an auxiliary feed-back loop recruits existing cerebral and spinal pathways. Wolf [7], favoring the latter explanation, posited that vis-ual and auditory feedback activate unused or underusedsynapses in executing motor commands. As such, continued training could establish new sensory engrams andhelp patients perform tasks without feedback [7]. Overall,biofeedback may enhance neural plasticity by engaging
Published: 21 June 2006
 Journal of NeuroEngineering and Rehabilitation
 2006,
3
:11doi:10.1186/1743-0003-3-11Received: 25 October 2005Accepted: 21 June 2006This article is available from: http://www.jneuroengrehab.com/content/3/1/11© 2006 Huang et al; licensee BioMed Central Ltd.