A patient with spastic hemiplegia struggles with sit-to-stand transitions due to co-contraction of muscles. What initial biofeedback protocol is recommended for knee extension exercise?

The recommended biofeedback protocol for a patient with spastic hemiplegia struggling with sit-to-stand transitions due to co-contraction involves using low detection sensitivity with recording electrodes placed closely together.

In this context, low detection sensitivity is beneficial because it allows for a more general and less sensitive measurement of muscle activation, which is particularly useful when dealing with patients who have spasticity, as high sensitivity may pick up unintended and excessive muscle activity due to co-contraction. By reducing sensitivity, the focus can shift to facilitating effective muscle activation for knee extension without overwhelming the patient with feedback about unintentional contractions.

The placement of the electrodes closely together enhances the detection of specific muscle activity relevant to the exercised muscle group (in this case, the muscles responsible for knee extension). This proximity ensures a more accurate representation of the target muscle, minimizing cross-talk with adjacent muscles, which can be especially problematic in spastic conditions where co-contraction of muscles can complicate intended movements.

Thus, employing low sensitivity with close electrode placement is an effective strategy to promote better control and functional movement patterns in patients with spastic hemiplegia, aiding their recovery and improving their sit-to-stand transitions.