Assessment & Research

Surface electromyography‐based biofeedback and knee rehabilitation: A review of the literature

Armshaw et al. (2023) · Behavioral Interventions 2023
★ The Verdict

This knee-rehab review is not for daily ABA use, yet it models how biofeedback plus practice can boost outcomes.

✓ Read this if BCBAs curious about biofeedback or who co-treat with PTs or OTs.
✗ Skip if Clinicians focused only on autism or classroom behavior.

01Research in Context

01

What this study did

Armshaw et al. (2023) read every paper on muscle-sensor biofeedback for knee rehab.

They looked at studies where injured knees got biofeedback plus exercise versus exercise alone.

The review did not pool numbers; it just described what each study found.

02

What they found

Adding muscle-sensor feedback to knee exercises may help patients more than exercise alone.

The authors say the signal is promising but warn the evidence is still thin.

No firm effect size was given because the studies used different methods.

03

How this fits with other research

Like Rojahn et al. (2012) with robot therapy for autism, this review calls the tech "exploratory."

Both papers say the tools look cool but need stronger trials before wide use.

McDonald et al. (2024) also maps a sparse literature, matching the "more research needed" tone here.

Gasiewski et al. (2021) shows BCBAs already team with OTs; this knee tech could be another joint project.

04

Why it matters

You probably won’t use muscle sensors for knee rehab, but the paper shows how biofeedback can pair with exercise.

That same logic applies when you add heart-rate feedback to anxiety treatment or EMG feedback to feeding therapy.

Think of it as a reminder: measure the body, give clear feedback, and practice the skill together.

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→ Action — try this Monday

Pick one client goal (like relaxed shoulders) and add a simple biofeedback cue (like a phone app tone) during practice.

02At a glance

Intervention
not applicable
Design
narrative review
Population
not specified
Finding
not reported

03Original abstract

AbstractThe number of total knee arthroplasties (TKA) performed yearly is rapidly increasing. Additionally, upwards of 50% of patients who receive TKA never achieve a full functional recovery. This suggests considerable room for improvement. This need for improvement expands beyond TKA as similar effects are noted across knee injuries. Electromyography‐based biofeedback (EMGBF) involves the delivery of feedback based on the activity of targeted muscle. By providing feedback contingent on changes in muscle amplitude, EMGBF may be an effective tool for strengthening quadricep muscles. This review aims to evaluate the utility of sEMGBF during physical therapy for various knee injuries. All studies were evaluated for the effectiveness of sEMGBF at improving muscle strength, range of motion, and reducing pain. Most studies reviewed found that including sEMGBF in physical therapy produced greater clinical benefits for patients than exercise alone. Further research is necessary to determine the best practice for including EMGBF in physical therapy.

Behavioral Interventions, 2023 · doi:10.1002/bin.1907