Recent developments in biofeedback for neuromotor rehabilitation

Abstract

The original use of biofeedback to train single muscle activity in static positions or movement unrelated to function did not correlate well to motor function improvements in patients with central nervous system injuries. The concept of task-oriented repetitive training suggests that biofeedback therapy should be delivered during functionally related dynamic movement to optimize motor function improvement. Current, advanced technologies facilitate the design of novel biofeedback systems that possess diverse parameters, advanced cue display, and sophisticated control systems for use in task-oriented biofeedback. In light of these advancements, this article: (1) reviews early biofeedback studies and their conclusions; (2) presents recent developments in biofeedback technologies and their applications to task-oriented biofeedback interventions; and (3) discusses considerations regarding the therapeutic system design and the clinical application of task-oriented biofeedback therapy. This review should provide a framework to further broaden the application of task-oriented biofeedback therapy in neuromotor rehabilitation.

Figure 1

General architecture of a multisensing task-oriented biofeedback system. The detailed functions of each module in the flowchart are described in Table 1.

Figure 2

Virtual environment design. The design of a virtual living room is illustrated. The virtual arm animates the patient's arm movement in real time. The patient can explore the virtual environment and perform the goal-directed reaching task. The green line indicates the ideal trajectory. The cone shape constrains the spatial error of endpoint position and provides direct knowledge of performance [72].

Figure 3

Musical feedback design. Musical notes are distributed along the hand's path from initial location to the target. Reaching a particular distance triggers the corresponding note to play. The curve indicates the hand-to-target distance during the arm reaching and withdrawal [72].