• The Journal of Korean Physical Therapy
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• v.25 no.2
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• pp.81-87
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• 2013

Purpose: The purpose of the current study was to examine the effects of electromyography (EMG)-biofeedback training on lower extremity muscle activity and balance of patients with total knee replacement (TKR). Methods: Subjects were randomly allocated to two groups: experimental and control group. Subjects in the experimental group (n=10) were provided with quadriceps setting exercise by EMG-biofeedback (QSE+BF) and those in the control group were provided with QSE. Subjects in both groups were provided with the respective training programs for 20 minutes per session, five times per week, for a period of six weeks. To test significance, data analysis was performed using repeated-ANOVAs. Results: Statistically significant differences in muscle activity of the rectus femoris muscle and the vastus lateralis, and dynamic balance ability were observed in the experimental group, compared with the control group. In comparison of the muscle activity of the rectus femoris muscle and the vastus lateralis, and dynamic balance ability between different training periods within the groups, both groups showed statistically significant differences. Conclusion: EMG-biofeedback training is effective in improving lower extremity muscle activity and balance ability of patients with TKR, and should be effective in patients with other diseases.

• Journal of the Korean Society of Physical Medicine
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• v.18 no.4
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• pp.109-119
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• 2023

PURPOSE: The definition and scope of biofeedback are broad and lack a clear framework. Therefore, efforts are needed to clearly understand the exact range and definition of biofeedback based on the research and development conducted to date. Thus, the purpose of this study was to arrive at the definition and scope of biofeedback through a literature review and analysis of its application methods. METHODS: This study is a systematic literature review conducted to understand the various types and effects of biofeedback. International databases such as Google Scholar and PubMed were used. Domestic databases utilized for keyword searches included the Research Information Sharing Service (RISS) and the National Digital Science Library (NDSL). Quality assessment of the selected studies in the selection process was done using the Cochrane risk of bias, and the research was analyzed according to the population, intervention, control, and outcomes (PICO) format. RESULTS: Studies conducted between 2019 and 2021 were selected, with 4 papers falling under physiological classifications and 7 under biomechanical classifications. The quality assessment results showed that random sequence generation, allocation concealment, performance bias, and reporting bias were unclear. Detection bias was moderate, and attrition bias and other biases were low. Out of the 11 papers, 9 dealt with physical function outcomes, 5 with daily life activities, and 3 with mental functions. CONCLUSION: Physiological biofeedback tended to influence psychological factors more than physical functions, while biomechanical biofeedback tended to have a positive impact on physical functions.

• Physical Therapy Korea
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• v.18 no.1
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• pp.9-17
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• 2011

The purpose of this study was to assess visual biofeedback's influence on trunk muscles' (EMG) activity and endurance holding time for correct position during whole-body tilt exercise. For the study, we recruited 14 volunteers who showed no symptom of lumbar disease during medical tests. We measured the EMG activity of their rectus abdominis, external abdominal oblique, internal abdominal oblique and erector spinae muscles, and their endurance holding time for correct position during $40^{\circ}$ anterior and posterior whole-body tilt under two conditions: whole-body tilt with and without visual biofeedback. Resistance with gravitational force on the trunk during whole-body tilt was applied by using a device that had a monitor on which the subjects could check their alignment and that sounded an alarm if a subject's alignment collapsed. The study showed an increase in the EMG activity of external abdominal oblique, internal abdominal oblique/rectus abdominis ratio and endurance holding time for correct position during both $40^{\circ}$ anterior and posterior whole-body tilt with visual biofeedback compared with without visual biofeedback (p<.05). We suggest that the whole-body tilt exercise with visual biofeedback could be a beneficial strategy for selectively strengthening the internal abdominal oblique muscle and minimizing the rectus abdominis muscle's activity while maintaining correct alignment during whole-body tilt exercise.

• PNF and Movement
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• v.18 no.1
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• pp.107-116
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• 2020

Purpose: To investigate the effects of electromyography (EMG) biofeedback on the muscle activity of the trapezius, shoulder pain, function, and range of motion (ROM) in patients with subacromial impingement syndrome (SAIS). Methods: Sixteen patients (9 males and 7 females) with SAIS participated voluntarily. The main outcome measures were muscle activity of the trapezius, shoulder pain (VAS), ROM, and the shoulder pain and disability index (SPADI). Exercises with EMG biofeedback consisted of shoulder flexion in a standing position, shoulder external rotation in a side-lying position, and shoulder horizontal abduction in a prone position. Post measurements were taken immediately after EMG biofeedback training. Results: Middle and lower trapezius activity, as well as ROM, was significantly increased by exercise with EMG biofeedback (p<0.05). In addition, VAS and SPADI scores significantly decreased post-EMG biofeedback training (p<0.05). Conclusion: EMG biofeedback intervention is an effective exercise for SAIS patients to restore activity of the middle and lower trapezius and to improve pain, shoulder function, and ROM.

• Sleep Medicine and Psychophysiology
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• v.6 no.1
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• pp.38-45
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• 1999

Objectives: We explored the characteristics of physiological variables such as electrodermal response(EDR) and electromyography(EMG) in patients with insomnia, panic disorder, and other anxiety disorders. we aimed to decide the minimum sessions in biofeedback treatment to make the treatment effective and examine the effects of long-term biofeedback treatment by measuring the physiological variables. Methods: Thirty seven outpatients who received biofeedback treatment were divided into 3 groups according to the number of biofeedback sessions(patients who received 4-5 sessions, who received 6-9 sessions, and who received more than 10 sessions). We measured mean and delta values of EDR and EMG levels, and the Hamilton Anxiety Rating Scale(HARS), and Slef-Relaxation Inventory(SRI) in all patients. Data were analyzed by t-test and repeated measures analysis of variance. Results: The mean and delta values of EDR and EMG levels were not different among the 3 groups during the first 4 biofeedback sessions. However, patients who received more than 10 biofeedback sessions had higher baseline mean EDR value(F=2.233, p=0.036) in the first session, compared with other patients. In patients who received more than 10 biofeedback sessions, mean EDR was significantly reduced after $5^{th}$ session(F=10.41, p<0.01). They showed significant improvement in SRI scores at 12th biofeedback session(t=2.726, p<0.05) and in HARS scores at $6^{th}$(t=3.10, p<0.05) and $12^{th}$ biofeedback session(t=10.93, p<0.001). Conclusions: Wesuggest that patients should receive more than 5 biofeedback sessions to experience internal cues and get a good clinical response to biofeedback treatment.

• Journal of Convergence for Information Technology
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• v.7 no.4
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• pp.159-164
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• 2017

The aim of this study was to investigate the effects of scapular dynamic stabilization exercise(SDex) with electromyography(EMG) biofeedback on the upper trapezius(UT), pectoralis major(PM) and serratus anterior(SA) activities. Fifteen healthy male voluntarily participated in this study. A paired t-test was used for statistical analysis. The study showed, through EMG biofeedback, that EMG activity significantly decreased in the UT, PM and increased in the SA(P<0.05). These results suggest that SDex with EMG biofeedback is effective to selectively strengthen the SA. This article is meaningful in that it is the first article using SDex with EMG biofeedback.

• Physical Therapy Korea
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• v.28 no.3
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• pp.186-193
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• 2021

Background: While the formal test has been used to provide a quantitative measurement of core stability, studies have reported inconsistent results regarding its test-retest and intraobserver reliabilities. Furthermore, the validity of the formal test has never been established. Objects: This study aimed to establish the concurrent validity and test-retest reliability of the formal test. Methods: Twenty-two young adults with and without core instability (23.1 ± 2.0 years) were recruited. Concurrent validity was determined by comparing the muscle thickness changes of the external oblique, internal oblique, and transverse abdominal muscle to changes in core stability pressure during the formal test using ultrasound (US) imaging and pressure biofeedback, respectively. For the test-retest reliability, muscle thickness and pressure changes were repeatedly measured approximately 24 hours apart. Electromyography (EMG) was used to monitor trunk muscle activity during the formal test. Results: The Pearson's correlation analysis showed an excellent correlation between transverse abdominal thickness and pressure biofeedback unit (PBU) pressure as well as internal oblique thickness and PBU pressure, ranging from r = 0.856-0.980, p < 0.05. The test-retest reliability was good, intraclass correlation coefficient (ICC1,2) = 0.876 for the core stability pressure measure and ICC1,2 = 0.939 to 0.989 for the abdominal muscle thickness measure. Conclusion: Our results provide clinical evidence that the formal test is valid and reliable, when concurrently incorporated into EMG and US measurements.

• PNF and Movement
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• v.21 no.2
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• pp.255-263
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• 2023

Purpose: This study aims to investigate the immediate effects of electromyography (EMG) biofeedback training of the gluteus medius on dynamic balance during single leg squats in healthy individuals. Methods: The sample size in this study was estimated using the G-power program at an effect size of 0.4, a significance level (α) of 0.05, and a testing power of 0.90. In addition, as a result of considering the 10% dropout rate, this study recruited 21 healthy individuals (8 males and 13 females). All subjects measured the Y-balance test-lower quarter (YBT-LQ) and limits of stability (LOS) before and after a single leg squat (SLS) and SLS with EMG biofeedback training of the gluteus medius (SLSEB). They were trained for 10 minutes for each exercise, and two dynamic balance tests were performed three times. Results: There was a significant difference in the YBT-LQ score between the two exercises (p < 0.05). In the YBT-LQ score, there was a significant difference before and after SLS and SLSEB (p < 0.05). SLSEB showed a significantly higher YBT-LQ score than SLS (p < 0.05). There was a significant difference in LOM between the two exercises (p < 0.05). However, there was no significant difference between the two exercises. Conclusion: A single-leg squat with EMG biofeedback exercises is an effective method to improve dynamic balance, such as the YBT-LQ.

• Journal of Korean Physical Therapy Science
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• v.24 no.2
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• pp.9-16
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• 2017

Purpose: This study was conducted in order to examine the changes of muscle activitis of erector spine muscles and Gluteus maximus during the bridge exercise with adductor muscles. Method: After attaching the EMG device to the Gluteus maximus and erector spine muscles of the 100 healthy adult males in their 20s, applying the stabilizer pressure biofeedback device between the knees, the bridge movement was carried out 10 seconds. Result: During the exercise of the bridge movement, the muscular activities in erector spine and gluteus maximus were significantly different in ralation to the simultaneous contractive adductor muscles of the bridge(p<.05). Conclusion: Thus, the bridge exercise is carried out in conjunction with the simultaneous contraction of adductor muscles that suggests that the training are more effective in erector spine and gluteus maximus activities.

• Journal of International Academy of Physical Therapy Research
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• v.10 no.4
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• pp.1868-1872
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• 2019

Background: Lower trapezius muscle function is important for the prevention and treatment of shoulder injuries. However, scapular posterior tilt movement has been overlooked in lower trapezius strengthening exercise programs. Objective: To examine the effects of prone arm lifting with scapular posterior tilt (PALSPT) on trapezius muscles. Design: Crossover study Methods: 17 healthy males were recruited for participation in this study. Participants performed backward rocking diagonal arm lifting (BRDAL) and PALSPT. To train participants in scapular posterior tilt movements for PALSPT, visual biofeedback of scapular movements was provided using a motion sensor. Electromyography (EMG) activities of the middle and lower trapezius were recorded using a surface EMG system. Differences in middle and lower trapezius muscle activity between BRDAL and PALSPT exercises were analyzed. Results: Lower trapezius muscle activity was significantly greater during PALSPT than during BRDAL (p=.006). Although greater EMG activity was observed in the middle trapezius during PALSPT than during BRDAL, this difference was not significant (p=.055). Conclusions: The results of the present study indicate that scapular posterior tilt movements must be considered in lower trapezius muscle strengthening programs.