By Russ Paine, PT | Originally featured on MikeReinold.com
So how do I re-establish normal neurological function? The use of biofeedback is my preferential method of attacking the neurological deficit following surgery or injury.
New advances in biofeedback devices have recently allowed the ability to provide a general assessment of the patients’ EMG neurological status. The subjects’ ability to fire the inhibited muscle may now be conveniently measured by recording EMG activity of the involved extremity and comparing this to the opposite normally functioning muscle group.
The primary rationale for use of biofeedback is the belief that the patient should begin use their own “electrical system” as soon as possible through volitional contraction.
The concept known as order of recruitment lends support to the use of biofeedback to enhance volitional contraction. This order is based on the size principle. The Henneman Size Principle states that under load, motor units are recruited from smallest to largest. In practice, this means that slow-twitch, low-force, fatigue-resistant muscle fibers are activated before fast-twitch, high-force, less fatigue-resistant muscle fibers.
When using a biofeedback device, the clinician sets the goal for the inhibited muscle so that a strong voluntary effort is required by the patent for each contraction. This is visible to the patient and forces a strong contraction to reach the pre-set goal. I believe that voluntary contraction using biofeedback produces the greatest results in restoring muscle function early.
Keep an eye out for more to come in this series!