A total of 30 targeted training electromyographic biofeedback treatments were administered to the hemiplegic upper extremities of 12 chronic stroke and head-injured patients (TT group). The 30 treatments were divided into three series of 10 treatments each directed to the shoulders; the elbow; and the wrist, fingers, and thumb, respectively. Evaluations for function, active range of motion, and integrated EMG activity were undertaken five times before treatment (baseline measurements), after each series of 10 treatments, and at follow-up intervals for one year. Data from these evaluations were compared with those obtained over an identical time course from 14 chronic stroke and head-injured patients undergoing a motor copy procedure (MC group) in which the patients matched EMG output viewed on a screen from homologous upper extremity muscles. Both groups showed appropriate significant changes among many independent variables. Changes within the TT group, however, appeared more treatment-related, whereas changes among the MC group were latent, occurring more frequently at follow-up evaluations. There were no substantial correlations between EMG activity, active ROM, or function, thus highlighting the continuing difficulty of identifying a causative relationship between physiologic change and enhanced motor capabilities among patients with neurologic disorders. Nonetheless, the results do suggest that both techniques are of clinical benefit, with the motor copy technique offering potential cost-effectiveness because patients can self-train.

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