Laurence P. Ince

EMG biofeedback for handwriting disabilities: a critical examination of the literature

A critical examination of the literature on the use of electromyographic (EMG) biofeedback for problems of handwriting is presented. Examined are the procedures, results and conclusions of clinical treatments of writers cramp and the habilitation of writing. The major flaws in each study are discussed and conclusions drawn from the review are presented, the primary one being that EMG biofeedback of the muscles of the upper extremity has yet to be demonstrated as a treatment of choice for handwriting disabilities. The lack of a sound foundation of data is seen as the main reason for the paucity of investigations in this particular area. Suggestions for further work are offered.

EMG biofeedback with upper extremity musculature for relaxation training: A critical review of the literature

A critical review is presented of studies utilizing EMG biofeedback for relaxation of upper extremity musculature. Examined are experimental investigations with normal subjects and those with psychological problems, and clinical applications of the methodology for treatment of involuntary movements and anxiety. Articles are reviewed in terms of procedures, controls and results. It is determined that few valid conclusions can be drawn regarding the efficacy of upper extremity EMG biofeedback for relaxation and that further research is required prior to utilizing the technique clinically. Suggestions are offered for areas of investigation.

A Behavioral Approach to Motivation in Rehabilitation

This paper presents a critique of current methods employed to assess the motivation of rehabilitation patients, and points out the problem faced by the psychologist who is expected to motivate the problem patient. An alternative technique based upon Premack’s research is suggested, in which participation in therapy classes which are attended with a high probability is used as a reinforcer by making it contingent upon attending classes of lower probability. Two cases are described in which such a model was successfully employed. Some possible problems involved in implementing this approach are discussed.

A cross-modality approach for treatment of chronic pain: a preliminary report.

&NA; Three subjects, presenting a variety of chronic pain problems, were treated with a cross‐modality feedback technique. Their presenting pain intensity was matched to a pure tone auditory stimulus decibel level and in each session this stimulus was progressively reduced in loudness, with the subjects having the task of reducing their pain to match each new, lower decibel levels. Audiometric measures, responses to pain assessment scales, self‐reports, reports from hospital staff, and reductions in pain medications all demonstrated marked pain reduction in all cases. Follow‐up assessments revealed that the improvements were maintained long after treatment had been discontinued.

Experimental foundations of EMG biofeedback with the upper extremity: a review of the literature

This article reviews the experimental foundations of EMG biofeedback with the upper extremity. Considered are investigations on recruitment and training of single and multiple motor units in both normal and nonnormal subjects, on transfer of training effects from trained to untrained muscles, and on the relationship of reduced muscle output to relaxation. Examined are procedures, results, and conclusions of these basic studies. Problems noted in the research are discussed and suggestions are made for further work in the area.

Desensitization with an aphasic patient

Abstract Systematic desensitization was utilized to relieve anxiety in an aphasic man whose speech problem became magnified when he was confronted with certain anxiety-provoking situations. The need to look for variables which may be disabling a patient other than the actual physical disorder, and the feasibility of attempting behavioral procedures with rehabilitation patients is discussed.

Conditioned responding of the neurogenic bladder.

&NA; Classical conditioning techniques were employed to condition responding of the spastic neurogenic bladder in a man with quadriparesis and urinary incontinence secondary to spinal cord injury at the cervical level. A neutral stimulus of mild electrical stimulation to the thigh was paired temporally with an unconditioned stimulus (UCS) of stronger electrical stimulation of the lower abdomen, and then was presented alone as a conditioned stimulus (CS) to elicit the conditioned response (CR) of voiding. The previously neutral CS reliably elicited large amounts of urine and left little residual urine in the subjects bladder. Following the experimental sessions, the subject self‐applied the CS on a predetermined schedule during his daily routine outside of the laboratory. The CS initially was successful, but after several days the CR exhibited extinction. Additional CS‐UCS pairing sessions did not reinstate the responses satisfactorily. Aspects of the experimental procedure and the results are discussed as well as the feasibility of conditioning the human spinal cord in the absence of an intact central nervous system

Modification of verbal behavior through variable interval reinforcement in a quasi-therapy situation ☆

Abstract Principles from the operant conditioning laboratory were applied to the verbal behavior of female college students. An experimental setting was designed to replicate a psychotherapists office, and subjects were seen daily in a study using a functional research design. Variable interval reinforcement was employed to modify the rate of emission of positive self-reference statements. Results demonstrated that the verbal, scheduled reinforcement exerted a definite, marked effect on the verbal behavior of the subjects. All subjects conditioned to the schedules. Sequence of scheduling did not appear to be a significant variable. The feasibility of employing such techniques in actual psychotherapy is discussed.

The utilization of EMG biofeedback for the treatment of periorbital facial muscle tension.

A case is presented of EMG feedback for reduction of tension in the orbicularis oculi muscle of both eyes. Feedback was provided for reduced firing of the upper and lower segments of the muscle. Within 25 sessions for the left eye and 20 sessions for the right, muscle output was markedly reduced from baseline and the patient reported no longer experiencing discomforting sensations of tightness. Follow-up of the patient 3 months posttreatment revealed that the initial problem of muscle tension no longer existed.