The effect of EMG biofeedback on lower extremity functions in hemiplegic patients

The aim of this study was to investigate the efficacy of electromyography biofeedback (EMG BF) therapy in the treatment of ankle dorsiflexion which complicates ambulation in patients who developed hemiplegia after a cerebrovascular accident (CVA). A total of 40 patients attending the inpatient rehabilitation programme who developed hemiplegia after CVA were included in this randomized controlled study. The patients were randomly divided into two groups. In the 20 patients included in the EMG BF group, a visual and auditory EMG BF therapy was applied to tibialis anterior muscles, the extensor of the ankle, 5 days a week for 3 weeks in addition to conventional physiotherapy. The other 20 patients in the control group were only treated with conventional physiotherapy applications. All patients were evaluated for spasticity, ankle range of movement (ROM) scores, the Modified Motor Assessment Scale (MMAS) scores, Brunnstrom's neurophysiological assessment and EMG BF electrical muscle activity before and after treatment. There were significant improvements in the posttreatment ROM, Brunnstrom and MMAS values in both groups, whereas the levels of significance were mostly higher in the EMG BF group than in the control group. In addition, there were no significant changes in spasticity and electrical activity of tibialis anterior muscles in the control group while the EMG BF group demonstrated significant changes. This study showed that the clinical and functional parameters were improved by the use of EMG BF therapy for lower extremities, in addition to conventional rehabilitation programs, in hemiplegic patients with walking difficulty due to insufficient ankle dorsiflexion.