Efficiency of electromyography biofeedback with relaxation training on muscle activation, disability, and posture in chronic neck pain

Purpose: The aim of this study was to compare the effect of classical physiotherapy program in patients with chronic neck pain, in addition to relaxation training with electromyography biofeedback (EMG-BF) on muscle activation level, posture, and disability levels. Methods: In addition to classical physiotherapy program (Transcutaneous Electrical Nerve Stimulation, ultrasound, hotpack, and home exercise), Group 1 (n = 20, 17 females, 3 males, mean age= 44.85 ± 12.51) was treated with relaxation training with EMG-BF and only classical physiotherapy program was applied to Group 2 (n = 20, 15 female, 5 male, mean age = 43.84 ± 12.33). The treatment applied five days a week for four weeks. Visual Analogue Scale (VAS), goniometric measurements, superficial EMG-BF, Neck Pain and Disability Index (NPDI), and New York Posture Scale (NPS) were used to measure the activation levels of upper trapezius muscle before and after treatment. Results: In the muscle activation level, there was a significant improvement on the left trapezius in both groups (p=0.005), but in the first group only the right trapezius muscle showed improvement (p=0.003). There was a significant decrease in the scores of NPDI (p=0.012) and NPS (p=0.001). Conclusion: After treatment, improvement was seen in both groups, but EMG-BF group was found to be more effective in muscle activation, disability, and posture level. It has been concluded that the relaxation training with EMG-BF will provide more effective treatment results by adding classical physiotherapy programs in clinics.