Integrating electromyographic biofeedback in stroke rehabilitation: A paradigm shift in motor and psychological recovery

A retrospective study by Yu et al demonstrated the efficacy of adding electromyographic biofeedback to conventional rehabilitation in improving motor function and reducing anxiety in stroke survivors. This editorial contextualizes these findings within emerging neurorehabilitation trends, highlighting the shift toward integrated approaches that address physical and psychological sequelae. Pooled data from 15 studies (n = 1850) revealed that electromyographic biofeedback enhanced Fugl-Meyer Assessment scores for the upper (Cohen's d = 0.82) and lower limbs (d = 0.79), while reducing anxiety (Hamilton Anxiety Rating Scale: d = -0.75) and depression (Hamilton Depression Rating Scale: d = -0.71). Proposed mechanisms include enhanced neuroplasticity, improved motor unit recruitment, and real-time, feedback-driven self-regulation. We discuss the clinical implications of standardizing biofeedback protocols and address scalability in resource-limited settings. Future research should prioritize randomized controlled trials, neuroimaging correlates, and cost-effectiveness analyses.