Helping hemiparetics to help themselves. Sensory feedback therapy

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Abstract
Despite the presence of some voluntary movement, the loss of discrete control impairs functioning of the arm and hand in most hemiparetics. Hemiparetic patients (70) aged 12-78 yr, were treated and followed up for 6 mo.-3 yr. Electromyographic [EMG] activity monitored from dysfunctional primary movers during attempted movement was displayed to the patients as a continuous oscilloscopic trace, reflecting generated muscle activity and allowing its quantification. Coupled with operant conditioning techniques, these displays were modified gradually by reinforcing the patient''s effort with auditory feedback during successive approximations to a desired level. EMG displays often resulted in a progressive improvement of voluntary movement. More than half the patients acquired and retained purposive movements that meaningfully improved their functional capabilities.

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