The effects of EMG biofeedback on strength acquisition

This study investigated the effectiveness of electromyographic (EMG) biofeedback in maximizing strength gains and integrated electromyographic (IEMG) levels of the quadriceps muscle group resulting from an isokinetic exercise program. Twenty-one male volunteers recruited from physical education classes at a large southwestern university were randomly assigned to one of the following three treatment groups: (1) a biofeedback (BF) trained group, (2) a deception (DEC) trained group, and (3) a nonfeedback (NF) trained group. Subjects were trained and tested for strength by extension on a Cybex Isokinetic Exercise Machine at a speed of 30 degrees per second. Training sessions were performed three times per week for five weeks; pretest and posttest data were based on the best score of three trials of a 1-RM maximum effort. A pretraining to posttraining comparison indicated significant increases in strength (p<.001)and IEMG levels (p<.001) for all treatment groups when a pairedt test was applied to the data. A multivariate analysis of covariance (MANCOVA) revealed that the BF trained group showed significantly greater peak torque values than DEC and NF trained groups (p<.01) and produced significantly greater IEMG levels than the NF trained group (p<.05). Overall, these results were taken as supporting the hypothesis that a training program of combined isokinetics and EMG biofeedback produces significant gains in maximal force and IEMG activity of leg-extensor muscles.This research was conducted while the author was at the University of New Mexico, Albuquerque, New Mexico.     

Biofeedback training in frontalis muscle relaxation and enhancement of belief in personal control

The hypothesis that biofeedback training in frontalis muscle relaxation increases beliefs in internal (personal) locus of control was tested. Subjects were divided into two groups (internals and externals) based on Mirels' (1970) factor analyzedpersonal control subscale of Rotter's (1966) I-E Scale. Internal and external subjects were assigned randomly to one of three conditions: biofeedback (BF), false feedback (FF), or no feedback (NF). All subjects were measured on frontalis electromyographic (EMG) activity. Training consisted of three sessions spaced 1 week apart. Each session was comprised of a 5-minute baseline (nonfeedback) trial followed by a 20-minute experimental session. After each experimental session, subjects completed a questionnaire which assessed the extent to which they attributed their EMG performance to personal and environmental sources. After three sessions, subjects were posttested on the I-E Scale. Results indicated that subjects receiving BF reduced their EMG activity more than did subjects in either the FF or NF conditions, and this effect was maintained across all three sessions. Subjects who received BF shifted toward internal personal locus of control from pre- to posttesting, whereas no such change was found for either FF or NF subjects. Also, the relationship between BF training and change in personal locus of control was mediated by subjects attributing their EMG reduction more to personal effort than to properties of the task. Results are discussed in terms of the importance of contingent feedback as a determinant of cognitions of control.     

Flexibility development in sprinters using EMG biofeedback and relaxation training

This study compared the effectiveness of electromyographic (EMG) biofeedback and relaxation treatment in producing flexibility increases at the hip joint. Retention of flexibility gains and changes in sprinting performance were also examined. Fifteen male and 15 female athletes, predominantly sprinters, were matched according to age, sex, and flexibility and were randomly assigned to one of three groups. The control group received only the testing, the biofeedback group received visual and auditory EMG training, and the relaxation group received modified PMR and imagery exercises. Subjects in the two experimental groups were given eight twice-weekly 10-minute sessions and then were retested for flexibility. Retention of flexibility was reassessed 2 and 4 weeks later. Sprint performance improved for all groups. EMG biofeedback and relaxation treatment methods were no more effective than stretching exercises used by the control group for improving flexibility during the treatment period, but they did produce evidence of superior flexibility gains in the retention period. This may be important as flexibility has been reported to be related to the incidence of injuries.     

Effects of fatigue and recovery on electromyographic and isometric force- and relaxation-time characteristics of human skeletal muscle

Effects of fatigue produced by a maintained 60% isometric loading on electromyographic and isometric force-time and relaxation-time characteristics of human skeletal muscle were studied in 21 males accustomed to strength training. Fatigue loading resulted in a slight but not significant change in the maximal integrated EMG of a maximal isometric contraction, and a large decrease (20.4 +/- 6.3%, p less than 0.001) in maximal force. Fatigue loading increased (p less than 0.05-0.01) neural activation of the muscles during rapidly produced submaximal isometric forces, but had a considerable adverse effect (p less than 0.001) on the corresponding force-time characteristics. Correlations between the relative changes after fatigue in the IEMG/force ratio at the maximal force level, and in the IEMG/force ratios of the early phases of the force-time curve were not significant, but gradually became significant (p less than 0.01) at higher force levels. The average IEMG of the muscles in the relaxation phase of contraction remained unaltered by fatigue, while a marked deleterious change in the relaxation-time variables (p less than 0.001) occurred concomitantly. During the subsequent 3 min rest period considerable (12.1 +/- 7.0%, p less than 0.001) recovery was noted in the maximal force, with smaller (insignificant or p less than 0.05-0.01) changes in the force-time and relaxation-time variables, while the average IEMG of force production decreased (p less than 0.01-0.001). The present findings suggest that fatigue leading to a worsening in force-time, in maximal force and in the relaxation-time parts of a maximal isometric contraction might take place primarily in the contractile processes.     

The role of EMG awareness in EMG biofeedback learning

Underlying most research on biofeedback learning is a theoretical model of the processes involved. The current study tested a prediction from the Awareness Model: High initial EMG awareness should facilitate response control during EMG biofeedback training. Seventy-two undergraduates were assessed for forehead EMG awareness by asking them to produce target responses from 1.0 to 5.0 µV every 15 s for 16 trials. Based on this assessment, two groups (high and low awareness) were trained for 64 trials to produce these target levels with either EMG biofeedback, practice (no feedback), or noncontingent EMG feedback. A transfer task was identical to the initial assessment. During training, the biofeedback group deviated less from target than the practice and noncontingent groups. The biofeedback group was the only group to improve from initial EMG awareness activity. During transfer, only the low awareness biofeedback group remained below initial EMG awareness level. These findings can be interpreted in terms of the Two-Process Model.     

EMG biofeedback treatment of torticollis: a controlled outcome study.

Successful treatment of torticollis with electromyographic (EMG) biofeedback has been reported in a number of single case and single group studies. The present investigation represents the first controlled outcome study. Twelve torticollis patients were randomly assigned to EMG biofeedback or relaxation training and graded neck exercises (RGP). The procedure involved three sessions of baseline assessment, 15 sessions of EMG BF or RGP, 6 sessions of EMG BF or RGP plus home-management, 6 sessions of home-management alone, and follow-up 3 months after the end of treatment. A variety of outcome measures were used including physiological (EMG from the two sternocleidomastoid muscles, skin conductance level), behavioral (angle of head deviation, range of movement of the head), and self-report (depression, functional disability, body concept), therapist and "significant other" reports and independent observer assessment of videos. In both groups, neck muscle activity was reduced from pre- to posttreatment. This reduction was greater in the EMG biofeedback group. There was evidence of feedback-specific neck muscle relaxation in the EMG biofeedback group. Therefore, the outcome was not due to nonspecific factors and could be attributed to feedback-specific effects. Changes in skin conductance level showed that neck muscle relaxation was not simply mediated by a general reduction of "arousal." Significant improvements of extent of head deviation, and range of movement of the head, as well as reductions of depression were present, which were not different in the two groups. At the end of treatment, no patient was asymptomatic. Any therapeutic benefit was generally maintained at follow-up. The results and the procedural simplicity of RGP make the issue of cost-efficacy of EMG biofeedback a pertinent one. Further controlled outcome studies of EMG biofeedback treatment of torticollis with larger samples are required.     

The electromyographic DC potential as a correlate of muscular activity

The present experiment was undertaken to demonstrate the effect of muscular force as well as duration of muscular work on the electromyographic (EMG) DC potential. Thirty subjects had to lift different weights by flexing the right forearm within a defined and constant setting for 20 s. The experimental variables were weight (0.5, 1, 2, and 3 kg) and time. The EMG was recorded from the belly of the right biceps brachii muscle in a quasi-unipolar manner and split into an integrated ac channel (IEMG) and a dc channel (DC-EMG). The average IEMG showed a ramp-like shape. Analysis showed a positive relationship for weight (p less than 0.0001) and time (p less than 0.0001) with the IEMG. The average shape of the DC-EMG showed a negative initiation potential, a monotonically increasing negative potential during contraction (contraction potential), a positively peaking off potential and a slow return to baseline (after potential). Analyses of variance demonstrated a significant (p less than 0.001) relationship of weight to the magnitude of the initiation and the termination potential. Regression analyses displayed an inverse relationship of time to the termination (p less than 0.01) and to the resolution potential (p less than 0.001). The DC-EMG showed higher peaks (initiation and termination potential) for heavier weights. For the termination and after potential less positive deflections were found with increasing time (fatigue). A control condition (isometric contraction) indicated that the initiation, contraction, and termination potential of the DC-EMG may also be related to aspects of the movement. Results suggest that the DC-EMG is a more complex measure of muscular activity than the IEMG.     

Training-induced changes in neuromuscular performance under voluntary and reflex conditions

To investigate training-induced changes in neuromuscular performance under voluntary and reflex contractions, 11 male subjects went through heavy resistance (high loads of 70-120% of one maximum repetition) and 10 male subjects through explosive type (low loads with high contraction velocities) strength training three times a week for 24 weeks. A large increase (13.9%, p less than 0.01) in voluntary unilateral maximal knee extension strength with only slight and insignificant changes in time of isometric force production were observed during heavy resistance strength training. Explosive type strength training resulted in a small insignificant increase in maximal strength but in considerable shortening (p less than 0.05) in the time of force production. A significant increase (p less than 0.05) noted in the averaged maximal integrated electromyogram (IEMG) of the knee extensors during heavy resistance strength training correlated (p less than 0.01) with the increase in maximal strength. No changes were noted during training in reflex time components, but significant decreases (p less than 0.05) occurred in the peak-to-peak amplitudes of the reflex electromyograms (EMG) in both groups. The individual changes during training in the reflex EMG/force ratio were related (p less than 0.01) to the respective changes in IEMG/force ratio in voluntary contractions. The present observations support the concept of specificity of training, and suggest that specific training-induced adaptations in the neuromuscular system may be responsible for these changes in performance.     

EMG biofeedback treatment of torticollis: A controlled outcome study

Successful treatment of torticollis with electromyographic (EMG) biofeedback has been reported in a number of single case and single group studies. The present investigation represents the first controlled outcome study. Twelve torticollis patients were randomly assigned to EMG biofeedback or relaxation training and graded neck exercises (RGP). The procedure involved three sessions of baseline assessment, 15 sessions of EMG BF or RGP, 6 sessions of EMG BF or RGP plus home-management, 6 sessions of home-management alone, and follow-up 3 months after the end of treatment. A variety of outcome measures were used including physiological (EMG from the two sternocleidomastoid muscles, skin conductance level), behavioral (angle of head deviation, range of movement of the head), and self-report (depression, functional disability, body concept), therapist and significant other reports and independent observer assessment of videos. In both groups, neck muscle activity was reduced from pre- to posttreatment. This reduction was greater in the EMG biofeedback group. There was evidence of feedback-specific neck muscle relaxation in the EMG biofeedback group. Therefore, the outcome was not due to nonspecific factors and could be attributed to feedback-specific effects. Changes in skin conductance level showed that neck muscle relaxation was not simply mediated by a general reduction of arousal. Significant improvements of extent of head deviation, and range of movement of the head, as well as reductions of depression were present, which were not different in the two groups. At the end of treatment, no patient was asymptomatic. Any therapeutic benefit was generally maintained at follow-up. The results and the procedural simplicity of RGP make the issue of cost-efficacy of EMG biofeedback a pertinent one. Further controlled outcome studies of EMG biofeedback treatment of torticollis with larger samples are required.This work was funded by grants from the Medical Research Council and the Dystonia Society.     

Feedback delays and relaxation expectancies in EMG biofeedback

The use of noncontingent feedback controls in studies of the efficacy and process of electromyographic (EMG) biofeedback may yield results confounded by differential expectancies for relaxation. Furthermore, the role of expectancies in producing psychological and physical relaxation as well as reducing muscle activity is unclear. This study investigated the effects of feedback delays and induced relaxation expectancies on EMG activity and experienced relaxation. One hundred four non-clinical subjects participated in one auditory frontal EMG biofeedback training session. Subjects were assigned to one of four computerized feedback delay conditions (0.0037, 0.7493, 2.2481, 6.7444 s) and to one of two relaxation expectancy conditions (positive or negative). During 20 minutes of biofeedback training, all groups decreased frontal activity. Feedback delays interacted with training epochs in affecting EMG; the longest delay group reduced frontal activity more slowly than the shortest delay group during training. Positive relaxation expectancies produced greater experienced relaxation than did negative relaxation expectancies. Instrumental and expectancy factors in EMG biofeedback appear to operate independently of each other by reducing physiological activity and producing psychological relaxation respectively.     

Effects of alternative control procedures for electromyographic biofeedback relaxation training

Twenty-four college students participated in a single session of electromyographic (EMG) biofeedback in a comparison of three experimental control procedures commonly employed in biofeedback relaxation training research. One group received contingent EMG biofeedback from the forehead area, and each subject in this group served as his or her own control. Subjects in a second group received noncontingent EMG feedback from a tape recorder but were instructed to use the feedback signal to relax their forehead muscles (single blind). Subjects in a third group received the same auditory feedback as those in the second group but were not told the purpose or source of the feedback stimulus (yoked control). The contingent feedback group showed significantly less EMG activity when compared to the other two groups. However, this group did not exhibit significant EMG level decrements from the beginning to end of the session. This seemingly contradictory finding may have been due to statistically capitalizing on the artifactually high EMG level of the experimental and control groups, although the single-blind and yoked-control groups showed nonsignificant increases across the session. The single-blind group's data had a variance several times larger than the other two groups' variance. Findings are discussed with respect to a probing hypothesis as opposed to the previously offered frustration hypothesis. Of the three control procedures, the data suggest the yoked control as the procedure of choice for EMG biofeedback relaxation research.The authors would like to thank David Kazar and Claudia Coleman for their technical assistance with this article.     

Electromyographic biofeedback for tension control during fine motor skill acquisition

The presence of residual muscular tension has been implicated as a detrimental influence on the performance and learning of motor skills. A method for reducing muscular tension has been provided by the advent of biofeedback training. This study investigated the effects of tension-control training by electromyographic (EMG) biofeedback on learning and performance of the pursuit-rotor backing task. Thirty young adult males were pretested for pursuit-rotor (PR) tracking skill, ranked by performance scores, and divided into identical triplicates to form two experimental groups and a control group. After a total of 3 hours of EMG biofeedback training for the experimental groups, all subjects were reevaluated on the PR test. One experimental group received biofeedback during the posttests. Analysis of variance of pretest-posttest difference means andt tests of scores representing performance and tension indicated that the EMG biofeedback training (1) significantly reduced tension induced by the novel motor skill and (2) significantly improved performance of the motor skill. Transfer of tension-control training was shown to facilitate learning and performance more than direct EMG biofeedback during performance. Residual tension reduction during learning was particularly facilitated by EMG biofeedback training, a profound implication for the management of stress in a variety of situations.This investigation formed part of a Ph.D. dissertation research (1976) conducted by the author under the guidance of Dr. Donald E. Campbell, Department of Physical Education, and Dr. Carol A. Saslow, Department of Psychology, at Oregon State University.     

Biofeedback as a means to alter electromyographic activity in a total knee replacement patient

This paper presents a single case controlled study of a 75-year-old male having bilateral total knee replacement. Baseline EMG recordings demonstrated differential levels of vastus medialis and vastus lateralis muscle activity in both knees during exercise, with increased vastus lateralis activity compared to vastus medialis activity. The purpose of the study was to use electromyographic (EMG) biofeedback training to train the patient to equalize vastus medialis and vastus lateralis EMG activity during exercise. After 11 and 13 training sessions for the left and right knees, respectively, differences between vastus medialis and vastus lateralis activity had markedly decreased. Following the termination of biofeedback training, EMG activity during exercise showed a return toward baseline levels. Several concomitant changes in psychological and physical function were noted. These results suggested that EMG biofeedback can be used to train vastus medialis and vastus lateralis activity in total knee replacement patients, and that biofeedback training may produce positive benefits in other functional areas.     

The use and utility of EMG biofeedback with chronic schizophrenic patients

This study examined the efficacy of muscle relaxation training via electromyographic (EMG) biofeedback from the frontalis and forearm extensor muscles of schizophrenic inpatients. Thirty chronically hospitalized patients were randomly assigned to one of three conditions: EMG biofeedback from the forearm extensor and frontalis muscles, progressive relaxation, and a control group. Treatment consisted of one session of orientation and baseline, and six sessions of training. The results indicated that the schizophrenic patients receiving EMG training had significantly lower EMG recordings than the progressive relaxation group, which, in turn, was significantly lower than the control group. Analyses of covariance on the Tension-Anxiety scale from the Profile of Mood States revealed no significant effects, while finger-tapping rates were significantly improved only for the arm receiving feedback training in the EMG group. On the Nurses Observation Scale for Inpatient Evaluation the biofeedback group significantly improved on the Social Competence and Social Interest factors.     

Muscle activation during cycling at different cadences: Effect of maximal strength capacity

The purpose of this study was to examine the influence of maximal strength capacity on muscle activation, during cycling, at three selected cadences: a low cadence (50 rpm), a high cadence (110 rpm) and the freely chosen cadence (FCC). Two groups of trained cyclists were selected on the basis of the different maximal isokinetic voluntary contraction values (MVCi) of their lower extremity muscles as follow: F_min (lower MVCi group) and F_max (higher MVCi group). All subjects performed three 4-min cycling exercises at a power output corresponding to 80% of the ventilatory threshold under the three cadences. Neuromuscular activity of vastus lateralis (VL), rectus femoris (RF) and biceps femoris (BF) was studied quantitatively (integrated electromyography, IEMG) and qualitatively (timing of muscle bursts during crank cycle). Cadence effects were observed on the EMG activity of VL muscle and on the burst onset of the BF, VL and RF muscles. A greater normalized EMG activity of VL muscle was observed for the F_min group than the F_max group at all cadences (respectively F_min vs. F_max at 50 rpm: 17 ± 5% vs. 38 ± 6%, FCC: 22 ± 7% vs. 44 ± 5% and 110 rpm: 21 ± 6% vs. 45 ± 6%). At FCC and 110 rpm, the burst onset of BF and RF muscles of the F_max group started earlier in the crank cycle than the F_min group These results indicate that in addition to the cadence, the maximal strength capacity influences the lower extremity muscular activity during cycling.     

The relative effectiveness of three techniques to induce the trophotropic response.

The purpose of this study was to examine the relative effectiveness of electromyographic biofeedback training (EMG BFT), meditation, and progressive muscle relaxation (PMR) in eliciting a relaxation or trophotropic response as measured by frontalis muscle tension, heart rate, electrodermal response, respiration rate, and skin temperature. Fifty-four college students were randomly assigned to one of five groups: (1) control, (2) placebo control, (3) EMG BFT, (4) meditation, (5) PMR. After baseline measures were obtained subjects were trained in 10 30-minute training sessions and posttested. Comparisons by ANOVAs indicated there was a significant decrease in muscle tension in the EMG BFT and meditation groups and significant decreases in respiration rate in the meditation and PMR groups. No other changes were attributed to treatment.     

The effects of frontal EMG biofeedback and progressive relaxation upon hyperactivity and its behavioral concomitants

Hyperactive children (N = 15) and nonhyperactive children (N = 15) were compared. Hyperactive children were found to possess significantly higher (p less than .002) muscular tension levels and, in addition, presented more behavioral problems and had lower test scores. Both electromyographic (EMG) biofeedback and progressive relaxation exercises were successful in the significant reduction of muscular tension, hyperactivity, distractability, irritability, impulsivity, explosiveness, aggressivity, and emotionality in hyperactive children. The greatest improvement was seen in the area of "emotionality-aggression" (irritability, explosiveness, impulsivity, low frustration tolerance, aggresion). No differences were seen in the EMG improvement of drug and nondrug hyperactive children; both made progress under these self-control techniques. However, nondrug children made greater improvements in the behavioral area. Both EMG biofeedback and progressive relaxation resulted in improvements on the test scores of hyperactive subjects (Bender-Gestalt, Visual Sequential Memory, Digit Span, Coding). The therapy would appear to be improved by the inclusion of mental relaxation, concentration, meditation, and mind-blanking exercises for mental control.     

Biofeedback as a means to alter electromyographic activity in a total knee replacement patient

This paper presents a single case controlled study of a 75-year-old male having bilateral total knee replacement. Baseline EMG recordings demonstrated differential levels of vastus medialis and vastus lateralis muscle activity in both knees during exercise, with increased vastus lateralis activity compared to vastus medialis activity. The purpose of the study was to use electromyographic (EMG) biofeedback training to train the patient to equalize vastus medialis and vastus lateralis EMG activity during exercise. After 11 and 13 training sessions for the left and right knees, respectively, differences between vastus medialis and vastus lateralis activity had markedly decreased. Following the termination of biofeedback training, EMG activity during exercise showed a return toward baseline levels. Several concomitant changes in psychological and physical function were noted. These results suggested that EMG biofeedback can be used to train vastus medialis and vastus lateralis activity in total knee replacement patients, and that biofeedback training may produce positive benefits in other functional areas.The authors wish to express thanks to Dr. Karen Gil for her helpful comments on a draft of this article, and Christianne Herman and Allison Roodman for their help in data collection and entry.     

Baseline levels in muscle relaxation training

Variations in the baseline levels of physiological measures, a familiar problem in psychophysiological research, can affect the results of clinical applications and research in the self-control of bodily processes. In this presentation, the problem is illustrated within the context of skeletal muscle relaxation training using continuous biofeedback (BF) based on surface electromyographic (EMG) activity. In terms of the Law of Initial Values (LIV), higher EMG levels are expected to be associated with greater decreases during training. The combined results of two studies documented an LIV-like effect for pretraining baseline levels with greater EMG decreases after training for subjects with the higher pretraining baselines. Left uncorrected, such baseline differences were shown to lead to discrepant results between two identical studies, and therefore to conflicting conclusions about the effectiveness of these procedures. The available methods suggested to correct for the biasing effect of baseline differences in research are described, with particular emphasis on the analysis of covariance.