Subgroup analysis assessed limb function improvement, stratified by assessment time point.

SMD, standardized mean difference. Tests for weight and heterogeneity between subgroups were derived from random effects models.</p

Pooled effects of different limb function scales after electromyographic biofeedback therapy as compared with control interventions.

Pooled effects of different limb function scales after electromyographic biofeedback therapy as compared with control interventions.</p

The PRISMA-checklist.

BackgroundUpper and lower limb impairment is common after stroke. Electromyographic biofeedback therapy is a non-invasive treatment, and its effectiveness in functional rehabilitation of the limb after stroke still remains uncertain.ObjectiveThe objective of this study was to evaluate whether electromyographic biofeedback can improve upper and lower limb dysfunction in stroke patients.MethodsPubMed, Embase, Cochrane Library, and Physiotherapy Evidence Database (PEDro) were searched from inception to 1st May 2022. Inclusion criteria were randomized controlled clinical trials of electromyographic biofeedback therapy interventions reporting changes in upper and lower limb function in post-stroke patients. Data were extracted by two independent reviewers and pooled in random-effects models using Review manager (RevMan) software.ResultsOur analyses included 10 studies enrolling a total of 303 participants. Electromyographic biofeedback therapy can effectively improve limb function after stroke (standardized mean difference [SMD], 0.44; 95% confidence interval [CI], 0.12–0.77; P = 0.008) and in subgroup analyses, the effect sizes of short-term effect (SMD, 0.33; 95% CI, 0.02–0.64; P = 0.04) was significant, but the long-term was not (SMD, 0.61; 95% CI, -0.11–1.33; P = 0.10). In addition, Electromyographic biofeedback therapy can improve the active range of motion of shoulder (SMD, 1.49; 95% CI, 2.22; PConclusionIn this meta-analysis, electromyographic biofeedback therapy intervention can improve upper and lower limb function in patients with stroke. Short-term (less than one month) improvement after electromyographic biofeedback therapy was supported, while evidence for long-term (more than one month) benefits was lacking. Range of motion in the glenohumeral and wrist joints were improved. Stronger evidence for individualized parameters, such as optimal treatment parameters and intervention period, is needed in the future.Systematic review registration[https://www.crd.york.ac.uk/prospero/display_record.php?recordID=267596], identifier [CRD42022354363].</div

Risk of bias assessment for studies using the RoB2 tool risk of bias summary for individual studies.

Risk of bias assessment for studies using the RoB2 tool risk of bias summary for individual studies.</p

Secondary outcomes: Forest plot of barthel index.

BackgroundUpper and lower limb impairment is common after stroke. Electromyographic biofeedback therapy is a non-invasive treatment, and its effectiveness in functional rehabilitation of the limb after stroke still remains uncertain.ObjectiveThe objective of this study was to evaluate whether electromyographic biofeedback can improve upper and lower limb dysfunction in stroke patients.MethodsPubMed, Embase, Cochrane Library, and Physiotherapy Evidence Database (PEDro) were searched from inception to 1st May 2022. Inclusion criteria were randomized controlled clinical trials of electromyographic biofeedback therapy interventions reporting changes in upper and lower limb function in post-stroke patients. Data were extracted by two independent reviewers and pooled in random-effects models using Review manager (RevMan) software.ResultsOur analyses included 10 studies enrolling a total of 303 participants. Electromyographic biofeedback therapy can effectively improve limb function after stroke (standardized mean difference [SMD], 0.44; 95% confidence interval [CI], 0.12–0.77; P = 0.008) and in subgroup analyses, the effect sizes of short-term effect (SMD, 0.33; 95% CI, 0.02–0.64; P = 0.04) was significant, but the long-term was not (SMD, 0.61; 95% CI, -0.11–1.33; P = 0.10). In addition, Electromyographic biofeedback therapy can improve the active range of motion of shoulder (SMD, 1.49; 95% CI, 2.22; PConclusionIn this meta-analysis, electromyographic biofeedback therapy intervention can improve upper and lower limb function in patients with stroke. Short-term (less than one month) improvement after electromyographic biofeedback therapy was supported, while evidence for long-term (more than one month) benefits was lacking. Range of motion in the glenohumeral and wrist joints were improved. Stronger evidence for individualized parameters, such as optimal treatment parameters and intervention period, is needed in the future.Systematic review registration[https://www.crd.york.ac.uk/prospero/display_record.php?recordID=267596], identifier [CRD42022354363].</div

Funnel plot of scale scores based on the limb function evaluation index.

Funnel plot of scale scores based on the limb function evaluation index.</p

Forest plot of subgroup sensitivity analysis by excluding studies with a high risk of bias.

Forest plot of subgroup sensitivity analysis by excluding studies with a high risk of bias.</p

Percentage graph of risk of bias across domains.

BackgroundUpper and lower limb impairment is common after stroke. Electromyographic biofeedback therapy is a non-invasive treatment, and its effectiveness in functional rehabilitation of the limb after stroke still remains uncertain.ObjectiveThe objective of this study was to evaluate whether electromyographic biofeedback can improve upper and lower limb dysfunction in stroke patients.MethodsPubMed, Embase, Cochrane Library, and Physiotherapy Evidence Database (PEDro) were searched from inception to 1st May 2022. Inclusion criteria were randomized controlled clinical trials of electromyographic biofeedback therapy interventions reporting changes in upper and lower limb function in post-stroke patients. Data were extracted by two independent reviewers and pooled in random-effects models using Review manager (RevMan) software.ResultsOur analyses included 10 studies enrolling a total of 303 participants. Electromyographic biofeedback therapy can effectively improve limb function after stroke (standardized mean difference [SMD], 0.44; 95% confidence interval [CI], 0.12–0.77; P = 0.008) and in subgroup analyses, the effect sizes of short-term effect (SMD, 0.33; 95% CI, 0.02–0.64; P = 0.04) was significant, but the long-term was not (SMD, 0.61; 95% CI, -0.11–1.33; P = 0.10). In addition, Electromyographic biofeedback therapy can improve the active range of motion of shoulder (SMD, 1.49; 95% CI, 2.22; PConclusionIn this meta-analysis, electromyographic biofeedback therapy intervention can improve upper and lower limb function in patients with stroke. Short-term (less than one month) improvement after electromyographic biofeedback therapy was supported, while evidence for long-term (more than one month) benefits was lacking. Range of motion in the glenohumeral and wrist joints were improved. Stronger evidence for individualized parameters, such as optimal treatment parameters and intervention period, is needed in the future.Systematic review registration[https://www.crd.york.ac.uk/prospero/display_record.php?recordID=267596], identifier [CRD42022354363].</div

Summary of leave-one-out sensitivity analysis for the effects on limb function after stroke.

Summary of leave-one-out sensitivity analysis for the effects on limb function after stroke.</p

Demographic and social characteristics of the included studies.

Demographic and social characteristics of the included studies.</p