Shoulder Musculoskeletal Disorder Rehabilitation Using a Robotic Device Based on Electromyography (EMG) Biofeedback: A Retrospective Cohort Study

<i>Background and Objectives</i>: While shoulder injuries represent the musculoskeletal disorders (MSDs) most encountered in physical therapy, there is no consensus on their management. In attempts to provide standardized and personalized treatment, a robotic-assisted device combined wit...

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Main Authors: Martin Lavallière, Mathieu Tremblay, Etienne Ojardias, Maxime Turpin, Anaïck Perrochon, Philippe Rigoard, Lisa Goudman, Maarten Moens, Romain David, Maxime Billot
Format: Article
Language:English
Published: MDPI AG 2025-02-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/61/2/272
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author Martin Lavallière
Mathieu Tremblay
Etienne Ojardias
Maxime Turpin
Anaïck Perrochon
Philippe Rigoard
Lisa Goudman
Maarten Moens
Romain David
Maxime Billot
author_facet Martin Lavallière
Mathieu Tremblay
Etienne Ojardias
Maxime Turpin
Anaïck Perrochon
Philippe Rigoard
Lisa Goudman
Maarten Moens
Romain David
Maxime Billot
author_sort Martin Lavallière
collection DOAJ
description <i>Background and Objectives</i>: While shoulder injuries represent the musculoskeletal disorders (MSDs) most encountered in physical therapy, there is no consensus on their management. In attempts to provide standardized and personalized treatment, a robotic-assisted device combined with EMG biofeedback specifically dedicated to shoulder MSDs was developed. This study aimed to determine the efficacy of an 8-week rehabilitation program (3 sessions a week) using a robotic-assisted device combined with EMG biofeedback (RA-EMG group) in comparison with a conventional program (CONV group) in patients presenting with shoulder MSDs. <i>Materials and Methods</i>: This study is a retrospective cohort study including data from 2010 to 2013 on patients initially involved in a physical rehabilitation program in a private clinic in Chicoutimi (Canada) for shoulder MSDs. Shoulder flexion strength and range of motion were collected before and after the rehabilitation program. Forty-four patients participated in a conventional program using dumbbells (CONV group), while 73 completed a program on a robot-assisted device with EMG and visual biofeedback (RA-EMG group); both programs consisted of two sets of 20 repetitions at 60% of maximal capacity. <i>Results</i>: We showed that the RA-EMG had significantly greater benefits than the CONV group for shoulder flexion strength (4.45 [2.6;6.15] kg vs. 2.3 [0.90;4.775] kg, U = 761, <i>p</i> = 0.013) and for normalized strength (77.5 [51.3;119.1] % vs. 39.1 [16.6;89.2] %, U = 755, <i>p</i> = 0.016). In addition, the RA-EMG group showed a trend to greater absolute gain of ROM than the CONV group (10.0 [0;24.3] degrees vs. 5.5 [0;12.0] degrees, U = 1931, <i>p</i> = 0.067), and a greater benefit in normalized ROM was observed for the RA-EMG (7.4. [0;17.7] %) than the CONV group (4.6 [0;10.8], U = 1907, <i>p</i> = 0.046). <i>Conclusions</i>: The current retrospective cohort study showed that a specific and tailored 8-week rehabilitation program with constant effort by automatic adjustment of the level of resistance by EMG feedback induced greater benefits for shoulder flexion strength and a trend to improve range of motion compared to conventional rehabilitation in patients with shoulder MSDs. Future research should be pursued to determine the added potential of this approach for abduction and external rotation with a randomized controlled design.
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spelling doaj-art-d8f756ca6b6f44f8a19013670c68b6da2025-08-20T02:04:06ZengMDPI AGMedicina1010-660X1648-91442025-02-0161227210.3390/medicina61020272Shoulder Musculoskeletal Disorder Rehabilitation Using a Robotic Device Based on Electromyography (EMG) Biofeedback: A Retrospective Cohort StudyMartin Lavallière0Mathieu Tremblay1Etienne Ojardias2Maxime Turpin3Anaïck Perrochon4Philippe Rigoard5Lisa Goudman6Maarten Moens7Romain David8Maxime Billot9Program of Kinesiology, Department of Health Sciences, Université du Québec à Chicoutimi (UQAC), Saguenay, QC G7H 2B1, CanadaProgram of Kinesiology, Department of Health Sciences, Université du Québec à Rimouski (UQAR), Rimouski, QC G5L 3A1, CanadaPhysical Medicine and Rehabilitation Department, University Hospital of Saint-Etienne, 42100 Saint-Etienne, FranceILFOMER (Institut Limousin de Formation aux Métiers de la Réadaptation), Université de Limoges, 87000 Limoges, FranceILFOMER (Institut Limousin de Formation aux Métiers de la Réadaptation), Université de Limoges, 87000 Limoges, FranceCHU de Poitiers, PRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), 86000 Poitiers, FranceDepartment of Neurosurgery, Universitair Ziekenhuis Brussel, 1090 Jette, BelgiumDepartment of Neurosurgery, Universitair Ziekenhuis Brussel, 1090 Jette, BelgiumCHU de Poitiers, PRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), 86000 Poitiers, FranceCHU de Poitiers, PRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), 86000 Poitiers, France<i>Background and Objectives</i>: While shoulder injuries represent the musculoskeletal disorders (MSDs) most encountered in physical therapy, there is no consensus on their management. In attempts to provide standardized and personalized treatment, a robotic-assisted device combined with EMG biofeedback specifically dedicated to shoulder MSDs was developed. This study aimed to determine the efficacy of an 8-week rehabilitation program (3 sessions a week) using a robotic-assisted device combined with EMG biofeedback (RA-EMG group) in comparison with a conventional program (CONV group) in patients presenting with shoulder MSDs. <i>Materials and Methods</i>: This study is a retrospective cohort study including data from 2010 to 2013 on patients initially involved in a physical rehabilitation program in a private clinic in Chicoutimi (Canada) for shoulder MSDs. Shoulder flexion strength and range of motion were collected before and after the rehabilitation program. Forty-four patients participated in a conventional program using dumbbells (CONV group), while 73 completed a program on a robot-assisted device with EMG and visual biofeedback (RA-EMG group); both programs consisted of two sets of 20 repetitions at 60% of maximal capacity. <i>Results</i>: We showed that the RA-EMG had significantly greater benefits than the CONV group for shoulder flexion strength (4.45 [2.6;6.15] kg vs. 2.3 [0.90;4.775] kg, U = 761, <i>p</i> = 0.013) and for normalized strength (77.5 [51.3;119.1] % vs. 39.1 [16.6;89.2] %, U = 755, <i>p</i> = 0.016). In addition, the RA-EMG group showed a trend to greater absolute gain of ROM than the CONV group (10.0 [0;24.3] degrees vs. 5.5 [0;12.0] degrees, U = 1931, <i>p</i> = 0.067), and a greater benefit in normalized ROM was observed for the RA-EMG (7.4. [0;17.7] %) than the CONV group (4.6 [0;10.8], U = 1907, <i>p</i> = 0.046). <i>Conclusions</i>: The current retrospective cohort study showed that a specific and tailored 8-week rehabilitation program with constant effort by automatic adjustment of the level of resistance by EMG feedback induced greater benefits for shoulder flexion strength and a trend to improve range of motion compared to conventional rehabilitation in patients with shoulder MSDs. Future research should be pursued to determine the added potential of this approach for abduction and external rotation with a randomized controlled design.https://www.mdpi.com/1648-9144/61/2/272rehabilitationshoulderelectromyography feedbackvisual biofeedbackassistive robotmusculoskeletal disorder
spellingShingle Martin Lavallière
Mathieu Tremblay
Etienne Ojardias
Maxime Turpin
Anaïck Perrochon
Philippe Rigoard
Lisa Goudman
Maarten Moens
Romain David
Maxime Billot
Shoulder Musculoskeletal Disorder Rehabilitation Using a Robotic Device Based on Electromyography (EMG) Biofeedback: A Retrospective Cohort Study
Medicina
rehabilitation
shoulder
electromyography feedback
visual biofeedback
assistive robot
musculoskeletal disorder
title Shoulder Musculoskeletal Disorder Rehabilitation Using a Robotic Device Based on Electromyography (EMG) Biofeedback: A Retrospective Cohort Study
title_full Shoulder Musculoskeletal Disorder Rehabilitation Using a Robotic Device Based on Electromyography (EMG) Biofeedback: A Retrospective Cohort Study
title_fullStr Shoulder Musculoskeletal Disorder Rehabilitation Using a Robotic Device Based on Electromyography (EMG) Biofeedback: A Retrospective Cohort Study
title_full_unstemmed Shoulder Musculoskeletal Disorder Rehabilitation Using a Robotic Device Based on Electromyography (EMG) Biofeedback: A Retrospective Cohort Study
title_short Shoulder Musculoskeletal Disorder Rehabilitation Using a Robotic Device Based on Electromyography (EMG) Biofeedback: A Retrospective Cohort Study
title_sort shoulder musculoskeletal disorder rehabilitation using a robotic device based on electromyography emg biofeedback a retrospective cohort study
topic rehabilitation
shoulder
electromyography feedback
visual biofeedback
assistive robot
musculoskeletal disorder
url https://www.mdpi.com/1648-9144/61/2/272
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