Electromyographic biofeedback for neuromuscular reeducation in the hemiplegic stroke patient: a meta-analysis

The efficacy of electromyographic biofeedback (EMG-BF) for neuromuscular reeducation in the stroke patient has been difficult to establish. The purpose of this study was to assess EMG-BF efficacy through meta-analysis. We searched the English-language clinical studies of biofeedback, stroke, and cerebral vascular disease between 1966 and 1991 using MEDLINE, PsycINFO, REHABDATA, and Dissertation Abstracts International. Studies were included in the analysis if (1) the patients sustained a cerebral vascular accident that resulted in hemiplegia, (2) the study had a randomized or matched control group, (3) the study measured a functional outcome, and (4) EMG-BF was the independent variable. Eight studies met the inclusion criteria (n = 192). Their average effect size was 0.81. The 95% confidence interval for the effect size was 0.5 to 1.12. These results indicate that EMG-BF is an effective tool for neuromuscular reeducation in the hemiplegic stroke patient.