Efficacy of electromyographic biofeedback compared with conventional physical therapy for upper-extremity function in patients following stroke: a research overview and meta-analysis.
OBJECTIVE
The purpose of this study was to examine the efficacy of electromyographic biofeedback compared with conventional physical therapy for improving upper-extremity function in patients following a stroke.


METHODS
A literature search was done for the years 1976 to 1992. The selection criteria included single-blinded randomized control trials. Study quality was assessed for nine criteria. For functional (disability index or stage of recovery) and impairment outcomes, meta-analyses were performed on odds ratios for improvement versus no improvement. Mann-Whitney U-Test probability values were combined across studies.


RESULTS
Six studies were selected, and outcome data were obtained for five studies. The common odds ratio was 2.2 for function and 1.1 for impairments in favor of biofeedback. The estimate of the number needed to treat to prevent a nonresponder was 11 for function and 22 for impairments. None of the meta-analyses were statistically significant.


CONCLUSIONS
The results do not conclusively indicate superiority of either form of therapy. Although there is a chance of Type II error, the estimated size of the effect is small. Given this estimate of little or no difference, therapists need to consider cost, ease of application, and patient preference when selecting these therapies.
Moreland
J
J
St Joseph's Hospital, Hamilton, Ontario, Canada.
Thomson
M A
MA
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001132:Arm / Q000503:physiopathology*; D015982:Bias; D001676:Biofeedback, Psychology / Q000379:methods*; D002561:Cerebrovascular Disorders / Q000503:physiopathology* / Q000534:rehabilitation*; D003131:Combined Modality Therapy; D016001:Confidence Intervals; D004576:Electromyography / Q000191:economics / Q000379:methods*; D005500:Follow-Up Studies; D017048:Health Care Costs; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D026741:Physical Therapy Modalities / Q000191:economics / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D015203:Reproducibility of Results; D012107:Research Design; D012720:Severity of Illness Index; D016037:Single-Blind Method; D016896:Treatment Outcome