Table 9: Augmented Feedback on Motor Functions

Author Year


Research Design


Total Sample Size

Methods Outcome

Kohlmeyer et al., 1996




NInitial=60; NFinal=45

Population: Mean age: 39 yr; Gender: males=40, females=5; Level of injury: C4-C6; Severity of injury: complete, incomplete.

Intervention: Extremities were randomly assigned to one of four treatment groups: 1. conventional strengthening; 2. electrical stimulation; 3. biofeedback and electrical stimulation; 4. biofeedback. Participation ranged from five to six weeks post SCI.

Outcome Measures: Manual muscle test, Activities of Daily Living (ADL) performance.



1.     Comparison of Groups (Increment or Decrement or No Change): no relationship between treatment group and observed change; no treatment produced a significantly higher proportion of individuals that improved relative to the proportion showing no change or a decrement; no change between treatment groups.

2.     Influence of Initial Muscle Grade: a correlation between the initial muscle grade and increment in muscle grade was seen at the end of treatment; poorer initial muscle grades, more likely to see a larger increment in muscle grade as a result of treatment.

Klose et al., 1993




NInitial=31; NFinal=28

Population: Age: 18-35 yr; Gender: males=24, females=4; Level of injury: C5-C7; Time since injury: ≥1 yr.

Intervention: Both groups received 45 min of aggressive exercise therapy three times per week for 12 weeks along with 30 min of neuromuscular stimulation (NMS) to assist with upper extremity muscle strength. Experimental group also received 12 wk of 30 min EMG biofeedback 3x/wk.

Outcome Measures: Manual muscle test, Functional activities score.

1.     Scores after training indicated no significant differences for the muscle test score and functional activities score between groups.

2.     Analysis of the repeated measures factor showed a significant change for the manual muscle test and functional activities score (p<0.05).

Effect Sizes: Forest plot of standardized mean differences (SMD±95%C.I.) as calculated from pre- and post-intervention data.

Brucker & Bulaeva 1996 USA



Population: Age: 17-63 yr; Gender: males=81, females=19; Level of injury: C2-C6; Time since injury: 1-29.7 yr.

Intervention: Electromyography (EMG) biofeedback treatment sessions.

Outcome Measures: EMG scores.

1.     T-test analysis of the differences before and after initial biofeedback treatment was done. An increase of 19.21% of normal EMG scores for right triceps and increase of 19.59% of normal EMG scores from the left triceps from one biofeedback treatment session were found, significant (p<0.001).

2.     T-test analysis of the difference from before initial biofeedback treatments to after additional treatments, increase in percentage of normal EMG scores of 41.55% right triceps and 38.31% left triceps, significant (p<0.001). Increases in percentage of normal EMG scores after initial biofeedback treatment to after additional biofeedback treatment 22.3% right triceps and 18.72% for left triceps, significant (p<0.001).

3.     Correlation coefficient for manual muscle test score and EMG pretest before initial treatment was r=0.569 for right triceps and r=0.437 for left triceps, significant (p<0.001).

4.     Increases in percentage of normal EMG before, after, and after additional treatments was significant in right and left triceps regardless of initial manual muscle test.