How Can Biofeedback Jumpstart Your Stroke Rehab Program?

Biofeedback can be used for the retraining of the arm and hand as a way to rehabilitate after a stroke. Following a stroke, the central pathways that are responsible for management of normal muscle tone and functioning can be disrupted or damaged. Some recent research out of Stanford University involving stem cells has discovered that those pathways may not be dead, just dormant. Here’s an interview that talks more about that study.

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Other motor pathways that are unused can remain relatively unaffected by the stroke. Biofeedback is one way that individuals can learn how to activate these unused pathways in the brain to improve motor function.

Biofeedback works by providing the user with visual reinforcement that a body part is being moved in the desired way. The concept is as simple as looking in the mirror to watch yourself move the arm or leg. “After a stroke, it is common for survivors to move their arms or legs abnormally,” says Dr. Richard L. Harvey, “medical director of the Stroke Rehabilitation Center at the Rehabilitation Institute of Chicago, otherwise known as the Shirley Ryan Ability Lab. “Biofeedback can train a stroke survivor to move more naturally.”

Biofeedback can be particularly helpful in helping someone isolate which muscle to use when there are two opposing muscles working against each other, as often happens after stroke. Learning to turn one set of muscles off, or relax them in order to get the opposing muscles to fire, can be one potential benefit of therapy involving biofeedback.

Using the RAPAEL Smart Glove, a user that may not have wrist extension activation but is able to flex the wrist, may work on turning off the flexor muscles or firing them in a more moderate way, in order to allow the extensor muscles to do their job of lifting the wrist, all while playing an engaging training game like Jewel Pong or or Throwing Darts.

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Game-based virtual reality (VR) like RAPAEL Rehab Solutions apply the principle of neuroplasticity while utilizing visual and auditory biofeedback. With VR the measured patient activity is fed back via graphs or audio and visual animations providing a realistic impression to the user. Visual biofeedback may also stimulate mirror neurons increasing the potential of the participant to mirror the movement. Virtual reality combined with biofeedback gives someone recovering from stroke the opportunity to interact safely with activities that appear similar to real-world situations.


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  • References
  1. Arya KN, Pandian S, Verma R, Garg RK. Movement therapy induced neural reorganization and motor recovery in stroke: A review. Journal of Bodywork and Movement Therapies. 2011; 15: 528-537. https://doi.org/10.1016/j.jbmt.2011.01.023
  2. Giggins OM, Persson UM, Caulfield B. Biofeedback in rehabilitation. Journal of Neuroengineering and Rehabilitation. 2013; 10: 1-11. doi: 10.1186/1743-0003-10-60
  3. Kommalapati R, Michmizos KP. Virtual reality for pediatric neuro-rehabilitation: Adaptive visual feedback of movement to engage the mirror neuron system. In Engineering in Medicine and Biology Society. 2016; IEEE 38th Annual International Conference of the (pp. 5849-5852).
  4. Henderson A, Korner-Bitensky N, Levin M. Virtual reality in stroke rehabilitation: A systematic review of its effectiveness for upper limb motor recovery. Topics in Stroke Rehabilitation. 2007; 14(2): 52. doi: 10.1310/tsr1402-52

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