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Comparison of Motor Copy and Targeted Biofeedback Training Techniques for Restitution of Upper Extremity Function Among Patients with Neurologic Disorders

S Wolf, PhD, FAPTA, is Professor, Department of Rehabilitation Medicine, and Associate Professor, Departments of Anatomy and Cell Biology and Surgery, Emory University School of Medicine, 1441 Clifton Rd NE, Atlanta, GA 30322 (USA).
D LeCraw, MMSc, is Senior Research Physical Therapist, Emory University Rehabilitation Research and Training Center, Emory University School of Medicine.
L Barton, MMSc, is Supervising Therapist, Physical Therapy Department, Donald Sharp Memorial Hospital, 7901 Frost St, San Diego, CA 92123.

A total of 30 targeted training electromyographic biofeedback treatments were administered to the hemiplegic upper extremities of 12 chronic stroke and head-injured patients (TT Group). The 30 treatments were divided into three series of 10 treatments each directed to the shoulders; the elbow; and the wrist, fingers, and thumb, respectively. Evaluations for function, active range of motion, and integrated EMG activity were undertaken five times before treatment (baseline measurements), after each series of 10 treatments, and at follow-up intervals for one year. Data from these evaluations were compared with those obtained over an identical time course from 14 chronic stroke and head-injured patients undergoing a motor copy procedure (MC Group) in which the patients matched EMG output viewed on a screen from homologous upper extremity muscles. Both groups showed appropriate significant changes among many independent variables. Changes within the TT Group, however, appeared more treatment-related, whereas changes among the MC Group were latent, occurring more frequently at follow-up evaluations. There were no substantial correlations between EMG activity, active ROM, or function, thus highlighting the continuing difficulty of identifying a causative relationship between physiologic change and enhanced motor capabilities among patients with neurologic disorders. Nonetheless, the results do suggest that both techniques are of clinical benefit, with the motor copy technique offering potential cost-effectiveness because patients can self-train.

Key Words: Biofeedback • Cerebrovascular disorders • Head injury • Hemiplegia, evaluation • Movement

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