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| Harnessing Covert Operants: Technology, Behavior, and the Future of Physical Medicine |
| Monday, May 26, 2025 |
| 10:00 AM–11:50 AM |
| Convention Center, Street Level, 143 A-C |
| Area: CBM; Domain: Translational |
| Chair: J. Logan Gibson (University of North Texas) |
| Discussant: Manish Vaidya (IBSTR) |
| CE Instructor: Brennan Patrick Armshaw, Ph.D. |
| Abstract: This symposium explores the integration of behavior analysis and measurement technology in enhancing physical health by showcasing studies leveraging surface electromyography (sEMG) to inform targeted behavioral interventions across various muscle systems. The first study examines the role of real-time sEMG-based visual feedback in improving fine motor skills in both young and older adults, specifically through non-dominant hand training, showing improvements in motor function. The second presentation highlights research on neuromuscular responses, exploring extinction processes and biofeedback-based rehabilitation for post-surgical recovery. The third presentation focuses on a comprehensive home-based intervention for urinary incontinence in homebound elderly adults, demonstrating improvements in muscle strength, social participation, and well-being. Finally, the fourth presentation explores sEMG-informed feedback to enhance muscle function in three critical systems—hyoid, pelvic floor, and vastus medialis oblique—demonstrating the efficacy of contingent feedback in improving function in the muscles related to swallowing, pelvic floor strength, and leg stability. Together, these studies demonstrate the promise of integrating behavior analysis with advanced technology to address diverse physical impairments, illustrating a path forward for innovative behavior analytic contributions to rehabilitation and novel physical medicine approaches. |
| Instruction Level: Basic |
| Keyword(s): Feedback, Healthcare, Physical medicine, Surface electromyography |
| Target Audience: Having a basic understanding of behavior principles is sufficient for this symposium. |
Learning Objectives: 1. discuss the use of modern technology to measure what were historically considered private events
2. provide examples of the scope in which behavior principles can be applied in healthcare
3. discuss the importance of contingent feedback in bodily processes |
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| Enhancing Fine Motor Skills in Older Adults Using Real-Time Surface Electromyography-Based Visual Feedback |
| (Applied Research) |
| YOSHITSUGU OMORI (Faculty of Medical Sciences, Shonan University of Medical Sciences/ Tokyo Metropolitan University), Jun'ichi Yamamoto (Tokyo Metropolitan University, Faculty of Systems Design) |
| Abstract: Fine motor impairments in hands can lead to long-term limitations in daily activities. Compensatory movement patterns can be adopted to restore functionality, with occupational and physical therapy often used as rehabilitation for hemiplegia, neurological disorders, and age-related decline. However, age-related deterioration of the neuromuscular and sensorimotor systems reduces the ability to receive feedback from bodily sensations, hindering the effectiveness of traditional training methods. Real-time feedback during practice may improve fine motor skill acquisition, particularly in older adults, by providing immediate performance information. This study investigated the immediate effects of real-time surface electromyography (EMG)-based visual feedback on chopstick use with the non-dominant hand, where muscle activity was measured, wirelessly transmitted, and displayed to participants in real-time. Young and older adults participated in the study. Dependent measures included the number of plastic pieces transferred between bowls in one minute, standardized fine motor skill scores, and subjective ratings recorded at baseline and post-intervention. The 10-minute intervention involved transferring plastic pieces with chopsticks using the non-dominant hand while receiving real-time surface EMG-based visual feedback. Results showed that real-time surface EMG-based visual feedback effectively improved fine motor performance. We will discuss how real-time visual feedback can be incorporated into rehabilitation. |
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Behavioral Science in Motion: Investigating Neuromuscular Activity From the Lab to the Clinic |
| (Applied Research) |
| BRENNAN PATRICK ARMSHAW (West Virgina University) |
| Abstract: The study of behavior at the neuromuscular level presents numerous opportunities for current and future behavioral scientists. These opportunities span both the basic and applied domains of the science of behavior. This talk aims to highlight some initial forays into the investigation, application, and conceptualization of neuromuscular responses with examples coming from the basic and the applied laboratory. The first study examines the mechanisms surrounding extinction at the neuromuscular level. Working with healthy undergraduate student participants, this study specifically examines the role of instructional control as it relates to response patterns and extinction bust probability. The second study moves out of the laboratory and into the clinic, specifically a physical therapy clinic. This portion of the talk will highlight how physical rehabilitation can be re-imagined through a behavioral lens. Data will be presented on the impact behaviorally informed approaches to biofeedback can have on the trajectory of post anterior cruciate ligament reconstruction recovery. For both studies, surface electromyographic technology serves as the primary measure of neuromuscular activity. The work aims to highlight a relatively unexplored area of behavioral science. An area of behavioral science likely to advance our understanding of basic behavioral processes and enrich applied practice for the betterment of patient quality of life. |
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| The Effects of a Comprehensive Intervention Program for Urinary Incontinence Symptoms in Homebound Elderly Adults |
| (Applied Research) |
| YOSHIMI SAKURAI (Shonan University of Medical Sciences; Tokyo Metropolitan University, Japan), Jun'ichi Yamamoto (Tokyo Metropolitan University, Faculty of Systems Design) |
| Abstract: Lower urinary tract dysfunction (LUTD) is a physical disability that interferes with activity and participation. Incontinence due to LUTD is associated with the development of frailty in the elderly and is a cause of reduced quality of life. Therefore, treatment of LUTD in the elderly requires exercise therapy to improve physical function, in addition to pharmacotherapy and behavioral interventions for lifestyle management. In this presentation, we report the efficacy of home-based exercise instruction by physical therapists (PTs). The participants were 22 elderly people with incontinence. The PT visited their homes once every two weeks to provide pelvic floor muscle training and lifestyle behavioral counseling at home. The participants recorded the frequency of incontinence and the performance of pelvic floor muscle training and received feedback from the PT. Three months after the intervention, subjects showed improved muscle strength index, decreased incontinence frequency, improved sense of well-being, and improvements in activity and participation, including increased opportunities to go outside and contribute to the community. These results demonstrate the effectiveness of a comprehensive intervention that integrates physical therapy and behavior analysis in the familiar home environment to improve activity, social participation, and health promotion in older adults. |
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| Improving Muscle Function Through Surface-Electromyography Informed Feedback: A Focus on Three Systems |
| (Applied Research) |
| J. LOGAN GIBSON (University of North Texas), Manish Vaidya (IBSTR) |
| Abstract: Skeletal muscle function is essential for human life, and disruption in muscle systems can result in reduced ambulation and organ dysfunction. Assessing muscle strength and determining the progress of exercises in muscles that do not involve joint angle changes, known as isokinetic exercises, can be challenging. Many muscles in the body naturally do not cause visible joint angle changes, while others may be restricted due to surgical procedures that contraindicate joint movement. Additionally, injuries or atrophied muscles may limit sensory feedback, complicating rehabilitation efforts and impacting daily life by affecting movement and essential bodily processes. Surface electromyography (sEMG) can address this issue by measuring motor unit recruitment, enabling targeted feedback to improve muscle performance. This presentation highlights sEMG-based feedback interventions for three muscle groups: the hyoid muscles, crucial for swallowing; the pelvic floor muscles, related to incontinence, sexual dysfunction, and pain; and the vastus medialis oblique, which supports locomotion and leg stability. In all cases, well-known behavioral interventions demonstrated efficacy, underscoring their potential for clinical application. These findings highlight the potential of sEMG-based feedback not only for rehabilitating key muscle groups but also for enhancing future clinical practices in muscle recovery and performance. |
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