Helping hemiparetics to help themselves. Sensory feedback therapy
J. Brudny, J. Korein, B. B. Grynbaum, P. V. Belandres and J. G. Gianutsos
Despite the presence of some voluntary movement, the loss of discrete
control impairs functioning of the arm and hand in most hemiparetics.
Seventy hemiparetic patients, aged 12 to 78 years, were treated and
followed up for six months to three years. Electromyographic activity
monitored from dysfunctional primary movers during attempted movement was
displayed to the patients as a continuous oscilloscopic trace, reflecting
generated muscle activity and allowing its quantification. Coupled with
operant conditioning techniques, these displays were modified gradually by
reinforcing the patient's effort with auditory feedback during successive
approximations to a desired level. Such therapeutic use of
electromyographic displays often resulted in a progressive improvement of
voluntary movement. More than half the patients acquired and retained
purposive movements that meaningfully improved their functional
capabilities.
