ABA Fundamentals

Treatment of severe hemifacial spasm with biofeedback. A case study.

Stanwood et al. (1984) · Behavior modification 1984
★ The Verdict

EMG biofeedback can shave off some muscle tension yet leave tic frequency untouched.

✓ Read this if BCBAs serving adults with neurological tics or spasms.
✗ Skip if Clinicians who only treat young children with developmental delays.

01Research in Context

01

What this study did

One adult with hemifacial spasm got EMG biofeedback.

The person watched a screen that showed tiny muscle signals.

They practiced relaxing the tense side of the face during 14 months of follow-up.

02

What they found

Muscle tension dropped a little while the person talked.

The twitch count stayed the same.

The change was small but still visible on the EMG trace.

03

How this fits with other research

Azrin et al. (1969) built the first EMG tone feedback. Bickel et al. (1984) used the same tool on a face instead of an arm.

Blanchard et al. (1979) and Yuwiler et al. (1992) also saw only tiny gains with blood-pressure and thermal biofeedback. Their pattern matches: biofeedback often relaxes muscles or pressure a bit, yet the main problem keeps ticking.

Moritz et al. (2011) got better results with a simple self-help trick for nail-biting. That study reminds us that low-tech behavioral moves can sometimes beat high-tech feedback loops.

04

Why it matters

If a client has tics or spasms, EMG biofeedback may calm the muscle but probably will not stop the movement. Pair it with habit-reversal or other behavioral tools for fuller change. Track both EMG numbers and real-world tic counts so you do not miss weak effects.

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Add a 5-minute EMG warm-up to habit-reversal practice, then count tics to see if the combo works better than either part alone.

02At a glance

Intervention
other
Design
case study
Sample size
1
Population
other
Finding
weakly positive
Magnitude
small

03Original abstract

A 35-year-old man with severe hemifacial spasm of 23 years' duration was treated with EMG biofeedback over five months. In addition to laboratory sessions and home sessions, the subject wore a pocket-size EMG monitor for a total of 472 hours during his daily activity. He could easily control his tic when attending to it, and also made major reductions in the frequency and EMG level when not attending (for example, during conversation) over the treatment period. At fourteen-month follow-up, two out of the three EMG measures taken during conversation were significantly lower than before treatment, but tic frequency during conversation was not. This report differs from other case reports in its careful attention to quantitative follow-up data and in the severity of the client's problem.

Behavior modification, 1984 · doi:10.1177/01454455840084007