Cognitive Muscular Therapy has been developed using electromyography (EMG) to visualise patient’s muscle patterns. With EMG, small electrodes are placed on the skin which measure activity in the underlying muscles. These signals are then transmitted wirelessly to computer. Using specifically developed software, patients are able to observe how their muscles activate, both in real-time during standing and also following performance of a functional task.
We recognise that many physiotherapists do not have access to an EMG system. Therefore, we are currently developing a modified version of the intervention which will use low-tech forms of biofeedback as an alternative to EMG. This is likely to incorporate mirror biofeedback along with strapping at the knee to facilitate awareness of a change in patella position and therefore quadriceps contraction. We acknowledge that this low-tech approach will not allow for nuanced tuning of muscle coordination during functional tasks. However, it will enable a physiotherapist to begin to integrate Cognitive Muscular Therapy into their practice without the need for an initial investment in equipment.