Targeting quadriceps inhibition with electromyographic biofeedback: a neuroplastic approach

Weakness of the quadriceps is a common occurrence in patients after knee injury or surgery; this weakness is due to a natural mechanism known as arthrogenic muscle inhibition. If inhibition of the quadriceps persists, it can become detrimental to a patient's function and lead to additional pathologies. A number of therapeutic interventions have be used in the rehabilitation of these patients, but few have proven to be successful. Electromyographic biofeedback is one modality that has demonstrated positive outcomes in patients by restoring quadriceps function. However, the reason for the effectiveness of this modality has yet to be fully explained in the area of rehabilitation. Neuroplasticity is a phenomenon that has gained much attention in rehabilitation, and its potential continues to grow. After an injury, the brain has the ability to enhance recovery by strengthening its neural circuitry. Through rehabilitation, clinicians can use attentional strategies to foster neuroplasticity and promote the recovery of their patients. In this article we provide reasoning for the effectiveness of electromyographic biofeedback using the evidence of neuroplasticity. With this information, we hope to provide clinicians a rationale for using this tool in the rehabilitation of patients with persistent quadriceps inhibition.