Journal of Neuroengineering and Rehabilitation Open Access Recent Developments in Biofeedback for Neuromotor Rehabilitation Review of Early Biofeedback Therapy Current Developments in Biofeedback in Neurorehabilitation Table 1: Function of Basic Modules in Multisensing Biofeedback Systems for Task T

The original use of biofeedback to train single muscle activity in static positions or movement unrelated to function did not correlate well to motor function improvements in patients with central nervous system injuries. The concept of task-oriented repetitive training suggests that biofeedback therapy should be delivered during functionally related dynamic movement to optimize motor function improvement. Current, advanced technologies facilitate the design of novel biofeedback systems that possess diverse parameters, advanced cue display, and sophisticated control systems for use in task-oriented biofeedback. In light of these advancements, this article: (1) reviews early biofeedback studies and their conclusions; (2) presents recent developments in biofeedback technologies and their applications to task-oriented biofeedback interventions; and (3) discusses considerations regarding the therapeutic system design and the clinical application of task-oriented biofeedback therapy. This review should provide a framework to further broaden the application of task-oriented biofeedback therapy in neuromotor rehabilitation. Biofeedback can be defined as the use of instrumentation to make covert physiological processes more overt; it also includes electronic options for shaping appropriate responses [1-3]. The use of biofeedback provides patients with sensorimotor impairments with opportunities to regain the ability to better assess different physiological responses and possibly to learn self-control of those responses [4]. This approach satisfies the requirement for a therapeutic environment to "heighten sensory cues that inform the actor about the consequences of actions (forward modeling) and allows adaptive strategies to be sought (inverse modeling)" [5]. The clinical application of biofeedback to improve a patient's motor control begins by re-educating that control by providing visual or audio feedback of electromyogram (EMG), positional or force parameters in real time [6,7]. Studies on EMG bio-feedback indicated that patients who suffer from sensori-motor deficits can volitionally control single muscle activation and become more cognizant of their own EMG signal [8,9]. The neurological mechanisms underlying the effectiveness of biofeedback training are unclear, however. Basmajian [10] has suggested two possibilities: either new pathways are developed, or an auxiliary feedback loop recruits existing cerebral and spinal pathways. Wolf [7], favoring the latter explanation, posited that visual and auditory feedback activate unused or underused synapses in executing motor commands. As such, continued training could establish new sensory engrams and help patients perform tasks without feedback [7]. Overall, biofeedback may enhance neural plasticity by engaging which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. auxiliary sensory inputs, thus making it …