A patient with spastic hemiplegia is referred for ambulation training. What biofeedback protocol should be used for knee extension?

In the context of biofeedback protocols for knee extension in a patient with spastic hemiplegia, using low-detection sensitivity with electrodes placed close together is the most appropriate choice. This approach allows for enhanced control by providing meaningful feedback to the patient.

When utilizing low-detection sensitivity, the biofeedback system is designed to register and respond to larger muscle contractions, which can be particularly beneficial in a patient with spasticity. The close placement of electrodes facilitates the capture of targeted muscle activity and increases the chances of detecting relevant muscle contractions effectively. This setup can improve the precision of the feedback, subsequently aiding in the patient's ability to gain better control over knee extension during ambulation training.

Additionally, the use of low-detection sensitivity can help manage the irregular and sometimes overly strong contractions associated with spasticity, as it reduces the likelihood of eliciting overwhelming feedback that might occur with high-detection settings. This balance is significant in promoting the engagement of the appropriate muscles for knee extension while avoiding additional complications from spastic reflexes.