Chulalongkorn Medical Journal


Background : Cerebral palsy has pathology in immature brain problem; ischemic brain,and hypoxic brain. The cause of the pathology can be prenatal, perinataland postnatal. EMG biofeedback is a muscles training program usingelectrical stimulation modality to train specific weakness of the muscles orpathologic side. Feedback response to the patients by visual or evidencesupporting sound can assist the patients to train themselves specifically.However, there are few evidences that support the efficacy ofelectromyographic (EMG) biofeedback in training of muscles in cerebral palsy.Objective : To study the effect of electromyographic biofeedback on upper extremitiesto improve hand function in children with cerebral palsy.Methods : Forty children with cerebral palsy who have impairment of the upperextremity and hand functions. The children were randomly assigned intotwo groups. Biofeedback group consisted of 20 patients that each receivedEMG biofeedback training of 3 muscles for 30 minutes plus three-tasktraining for 30 minutes. The conventional group consisted of 20 patientsthat received three-task training for 60 minutes. The upper extremity andhand functions were evaluated before starting the training, and then at4 weeks and 8 weeks.Results : Biofeedback group displayed statistically significant improvementregarding 3 subtests of Jebsen hand function test (JHFT) (P = 0.004,P = 0.017, P = 0.004). Comparing with before starting training, meandecreasing of time spending at 4th week were 15.03 ± 4.01, 232.42 ± 74.52 and 14.24 ± 3.80, and at 8th week were 13.32 ± 2.70, 251.85 ± 80.25and 10.34 ± 3.28. Conventional group displayed statistically significantimprovement regarding 1 subtest of JHFT (P = 0.006). Comparing withbefore starting training, the mean decreased of time spent at 4th weekwere 174.90 ± 49.20. Biofeedback group showed statistically significantprogress over the conventional group in 1 subtest of JHFT (P = 0.002,P = 0.005).Conclusion : Effect of EMG biofeedback on upper extremity and hand functions inchildren with cerebral palsy especially in large muscles trained by EMGbiofeedback is superior to the conventional therapy.



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