Surface electromyography holds great potential in helping patients recover from injuries that result in motor impairments. To be able to assist the patient, the clinician must consider research obtained from the study of implicit/ explicit learning, contextual interference, and basic learning theory. Quantitative surface electromyography (QSEMG) is a technique that is constructed around this basic research in order to present the optimal learning environment for the patient. Nobody quite knows how it is done, and any competent physicist would be inclined to deny a priori that it can be done.

We completed a retrospective review of the effectiveness of multi-site, performance-contingent reward programming on functional change in motor performance of 16 treatment resistant children. Patients were previously treated in physical or occupational therapy for head control, standing balance training, sitting and upper extremity use (brachial plexus injury). They then participated in a program that utilized multiple surface electromyography sites the use of which was rewarded with videos for performing the correct constellation of recruitment pattern (e.g., contracting some muscles while relaxing others). Onset of reward was calibrated for each patient and transfer of skill to outside the clinic was encouraged by linking a verbal cue to the correct motor plan. Fourteen of the 16 patients improved. The implications of the use of this technique in the treatment of motor dysfunction is discussed.

Modification of abnormal gait was attempted in real-time using a surface electromyography-based protocol to teach recruitment of the anterior tibialis at the correct time in the gait cycle. Two children diagnosed with cerebral palsy were able to learn volitional control of the anterior tibialis as demonstrated by improved clearance of the toe on the swing phase of the gait and newly learned ability to recruit and relax the anterior tibialis. The children were able to walk with the new gait pattern and reproduce the old one at will. Implications for future research in this area are discussed.

There are frequently used electrical terms in the biofeedback literature. Often it is assumed that the reader has detailed knowledge of these terms. The difficulty begins when seemingly familiar terms are used as a basis for an in-depth explanation of the process of electromyography. For example, the concept of impedance is based on three building blocks of electricity: current, voltage and resistance. The term "impedance" is found in every manual for biofeedback equipment with the suggestion that the electrode site be kept "low" and the encoder input "high". A little electrical knowledge can explain why this is so and in the process formulate a more thorough understanding of the equipment used everyday with a client.

Surface electromyography (SEMG) can be used as a tool to help gain the return/discovery of motor function in those with disabilities. This article presents the case of “Joey,” an 18-month-old toddler. An already challenging case due to age is made even more difficult considering his genetically based multiple impairments. SEMG provided a window of opportunity, previously unavailable, to allow Joey to demonstrate the new motor skills that he was capable of learning.

In this case study, surface electromyography (SEMG) was used to help a severely brain-damaged adolescent regain head control. In addition to relearning a lost motor skill, the patient, because of the extensiveness of the injury, had to overcome deficits in memory, visual processing, and cognitive tone. The process of quantitative SEMG was used to teach the patient to use a targeted series of muscles, which, in 14 weeks, brought her to the point that for many activities a headrest was no longer needed.

Surface electromyography, if used correctly, can be helpful in restoring lost function after a stroke or head injury. This article explains the basis for quantitative surface electromyography (QSEMG). QSEMG does not target discrete muscles; it targets a constellation of muscles in order to restore function.

Biofeedback is an effective tool for treating pediatric pain. As biofeedback professionals, we often work within an interdisciplinary team for complicated cases of pain. This interprofessional care of pediatric chronic pain presents both advantages and potential hurdles to the biofeedback clinician. In this article, we detail two current biofeedback services affiliated with interprofessional pediatric pain management. We then use case examples to demonstrate key issues in interprofessional care. We conclude with opportunities for further development of interprofessional care involving biofeedback and lessons learned from our practice that may be beneficial to others in the field.